Application For Admission

General Information
Full Name	Address
City	State: ALABAMA ALASKA ARIZONA ARKANSAS CALIFORNIA COLORADO CONNECTICUT DELAWARE FLORIDA GEORGIA HAWAII IDAHO ILLINOIS INDIANA IOWA KANSAS KENTUCKY LOUISIANA MAINE MARYLAND MASSACHUSETTS MICHIGAN MINNESOTA MISSISSIPPI MISSOURI MONTANA NEBRASKA NEVADA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEW YORK NORTH CAROLINA NORTH DAKOTA OHIO OKLAHOMA OREGON PENNSYLVANIA RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VERMONT VIRGINIA WASHINGTON WEST VIRGINIA WISCONSIN WYOMING
Zip
Social Security Number: **Please send SIN number with your application check.**	Date of Birth / /
Day Telephone -	Evening Telephone -
E-mail address	Automobile License Plate
In the event of an emergency, please contact
Address/Telephone
Relationship to you
Education
College	Graduation Date
Degree	GPA
Honors/Awards/Scholarships
Other Education
Computer Skills/Information
I have working knowledge of computerized: Word Processors Yes No Spreadsheets Yes No Databases Yes No
Do you have access to a computer to do your homework? Yes No
Do you have access to the Internet? Yes No
Employment and Volunteer Experience
Please send your resume or a similar description of your work and volunteer experience to admissions@mnparalegal.com. Include: Job Title, Employer and Dates of Employment.
Additional Information
Do you plan to work while enrolled in the program? Yes No
Will you be attending the program on a full-time or part-time basis? Full Time Part Time
Which session date do you wish to attend? (Month & Year)
Day or Evening? Day Evening
Are you, or is a member of your family a veteran of any branch of the armed services of the United States? Yes No
Your response to the following question is OPTIONAL and will be used only for our statistical reporting to the American Bar Association:
What is your predominant ethnic background?
I CERTIFY THAT THE INFORMATION CONTAINED IN THIS APPLICATION IS ACCURATE AS OF THIS DATE. I UNDERSTAND THAT IF IT IS FOUND TO BE OTHERWISE, I MAY BE SUBJECT TO REJECTION OR DISMISSAL.
Name	Date
The Minnesota Paralegal Institute does not discriminate on the basis of race, color, national origin, sex, religion, age or disability in employment or the provision of services.