The Ohio State University at Lima

Name

Address 

City    State    Zip 

Daytime Phone      Work    Home 

Evening Phone      Work     Home      Cell 

E-mail Address 

Social Work Areas of Interests 

Intended Area of Specialization (if known) 

Have you ever attended The Ohio State University before? Yes  No

Have you ever attended another college or university?  Yes No
If yes, Where? 

What year did you obtain your Bachelor's Degree? 

Do you have a BSSW? Yes  No

What was your cumulative GPA? 

The contents of the information package to be mailed to you are identical to the contents of the MSW web page. I would like printed brochures and materials sent to me.

I would like to enroll as Graduate Non-degree.  Please send me this information.

I would like to enroll in the Autumn 2012 MSW Program Cohort.

AU 2012 Cohort: Application period open
Deadline: ASAP: March 1, 2012; Regular: May 1, 2012

You may download the application packet from the links below

Download the application packet:

--Download the application and instructions  (MS Word, 93 KB  or pdf format, 279 KB)

    --Download the Recommendation form (MS Word,  or  pdf format )

Please send me an application packet for the AU 2012 Cohort.

Please add me to your mailing list to receive Social Work course offerings each quarter.