* Required Fields

I. Program of Interest

I am applying for the Program *
I would like to attend *

II. General Information

Last Name* First Name* Middle Initial
Street Address* City* State* Zip Code*
Home Phone * Cell Phone Business Phone
() - () - () -
E-mail Address*

Are you 18 years of age or older? Yes No

Gender: Female Male

Have you ever been known by any other name? Yes No

If Yes, what is the name?

Citizenship:
I am a		 US Citizen
Permanent Resident Alien | Registation Number:
Visa Holder | Visa Type:

Race (Optional)

Past Application/Enrollment:

Have you applied or attended Swedish Institute previously? Yes No

If YES, please specify Date of Application or Date of Enrollment:

Have you ever been convicted of a felony or misdemeanor? Yes No

If YES, please describe below and provide additional documentation clarifying the outcome of the case.

III. Education

Office transcripts must be sent directly to Swedish Institute in order to complete the admissions acceptance process.

Important Note: If you have completed your education outside of the United States, please refer to the "International Applicants" section of the Catalog.

Name of High School Graduation Date Diploma or GED
Street Address City State Zip

List all colleges/universitites and vocational/technical/professional schools attended. List most recently attended, first.

School Name City/State Dates Attended Graduation Date Degree

IV. Employment

List most recently first.

Employer Your Title Dates Employed Supervisor's Name
Street Address City State Zip

Employer Your Title Dates Employed Supervisor's Name
Street Address City State Zip

Employer Your Title Dates Employed Supervisor's Name
Street Address City State Zip

V. Acknowledgements

I certify that the information provided during this application process, both verbally, written and electronically, or documents submitted with my application, are accurate to the best of my knowledge. I understand that falsification of material is grounds for denial or dismissal.

Swedish Institute admits qualified students regardless of race, religion, national origin, gender identity, sexual orientation, age, marital status, or handicap.

Applications and associated documents become the property of Swedish Institute.

Applicants for the Nursing Program must submit a $50 non-refundable fee to process the application. (Payable in person)

If you have questions about your application, please call the Admissions Office at (212) 924-5900 x199.