Noncandidate Application

Autobiographical Information
Legal last name: *
Legal first name: *
Middle name:
Preferred first name:
Date of birth: mm/dd/yyyy *
Social Security number:
Sex: *
Ethnic group (optional):
Permanent Address
Street address *
City: *
State (if U.S.):
State/Province (if not U.S.):
Zip/Postal code:
Country: *
Telephone:
Email address: *
Citizenship
Citizen of the U.S.? *
If not, a citizen of what country?
Country of birth: *
Permanent resident of the U.S.?
If not, what is your U.S. visa status?
Semester/year for which you are applying *
Status *
Academic History
If you have attended any other colleges or universities (including Goucher), did you leave that institution in good academic and disciplinary standing? *
If no, please explain
Disciplinary History
  1. Have you ever been responsible for a disciplinary violation at any educational institution you have attended from 9th grade (or the international equivalent) forward, whether related to academic misconduct or behavioral misconduct, that resulted in your probation, suspension, removal, dismissal, or expulsion from the institution? *
  2. Have you ever been adjudicated guilty or convicted of a misdemeanor, felony, or other crime? (Note: You are not required to answer "yes" to this questions, or provide an explanation, if the criminal adjudication or conviction has been expunged, sealed, annulled, pardoned, destroyed, erased, impounded, shelded or otherwise ordered by the court to be kept confidential.) *
If you answered yes to either or both questions, please explain below, giving the approximate date of each incident, the circumstances, and reflects on what you learned from the experience.
I understand that, if I am accepted for admission, I will be expected to do the work required for each course for which I have registered and will receive a grade based on that work. I further understand that I will be classified as a non degree-seeking student, not as a candidate for the Goucher degree. I understand that I may choose to audit any course, and, therefore, waive my right to a grade for that course.

I understand that submitting this form is the equivalent to a signature.