On-Line Inquiry Form - Graduate

If you would like more information about our programs or admissions process, please complete the form below. If you have questions regarding admissions you can 1-413-748-3225, or e-mail us at graduate@springfieldcollege.edu.

	Information:
*First Name:
*Last Name:
Middle Initial:
Gender (optional):	Male Female
Are you a U.S. citizen/permanent resident?	Yes No
	Mailing Address:
Is this a school address or home address?	School Home
Street Address:
City:
State (US):	Choose one AK AL APO-AA APO-AE APO-AP AR AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MP MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY
Zip:
Country:
*Telephone:
Fax:
*Email Address:
	Program:
Intended Entry:	Spring 2013 Summer 2013 Fall 2013 Spring 2014 Summer 2014 Fall 2014 Spring 2015 Summer 2015 Fall 2015
Graduate Program of Interest:	Choose One *Art Therapy Business Administration *Education *Exercise Science & Sport Studies *Occupational Therapy *Health Studies *Physical Education Physical Therapy Physician Assistant *Psychology & Counseling *Rehabilitiation Counseling & Services *Social Work *Sport Management & Recreation Undecided *with
Graduate Concentration:	Choose One ART THERAPY/Clinical Art Therapy BUSINESS ADMINISTRATION/Management BUSINESS ADMINISTRATION/Non-profit Management EDUCATION/ Educational Studies EDUCATION/Early Childhood Education EDUCATION/Elementary Education EDUCATION/Secondary Education EDUCATION/Students with Moderate Disabilities EXERCISE SCIENCE AND SPORT STUDIES/Athletic Training EXERCISE SCIENCE AND SPORT STUDIES/Excercise Physiology EXERCISE SCIENCE AND SPORT STUDIES/Health Promotion and Disease Prevention EXERCISE SCIENCE AND SPORT STUDIES/Sport and Exercise Psychology EXERCISE SCIENCE AND SPORT STUDIES/Strength and Conditioning HEALTH STUDIES/Health Education Teacher Licensure OCCUPATIONAL THERAPY/Entry Level OCCUPATIONAL THERAPY/Post Professional PHYSICAL EDUCATION/Adapted Physical Education PHYSICAL EDUCATION/Advanced Level coaching PHYSICAL EDUCATION/Athletic Administration PHYSICAL EDUCATION/Physical Education Teacher Licensure PHYSICAL EDUCATION/Physical Education Teaching-Clinical PSYCHOLOGY AND COUNSELING/Athletic Counseling PSYCHOLOGY AND COUNSELING/Industrial/Organizational Psychology PSYCHOLOGY AND COUNSELING/Marriage and Family Therapy PSYCHOLOGY AND COUNSELING/Mental Health Counseling PSYCHOLOGY AND COUNSELING/School Counseling and Guidance PSYCHOLOGY AND COUNSELING/Student Personnel Administration REHABILITATION COUNSELING AND SERVICES/Alcohol and Substance Abuse Counseling REHABILITATION COUNSELING AND SERVICES/General Counseling and Casework REHABILITATION COUNSELING AND SERVICES/Pediatric and Developmental Disabilities REHABILITATION COUNSELING AND SERVICES/Psychiatric Rehabilitation and Mental Health REHABILITATION COUNSELING AND SERVICES/Rehabilitation-Special Services SOCIAL WORK/Advanced Standing-Weekday SOCIAL WORK/Advanced Standing-Weekend SOCIAL WORK/Combined MSW/JD Program SOCIAL WORK/Regular Weekday Program SOCIAL WORK/Regular Weekend Program SPORT MANAGEMENT AND RECREATION/Recreation Management SPORT MANAGEMENT AND RECREATION/Sport Management SPORT MANAGEMENT AND RECREATION/Therapeutic Recreation Management SPORT MANAGEMENT AND RECREATION/Therapeutic Recreation Management/Child-Life Specialist Track

What most influenced this inquiry?	Choose one Alumnus/a Viewbook Student Catalog Guidance Counselor Campus Visit YMCA Professional Reputation ECAC Website Other
If you chose "Other," please describe.
Comment (if any):
	Submitted (EST): 05/19/2013 06:08 PM