Application Form
1.
I am applying from (please check):
Hayek Foundation - Buenos Aires, Argentina
Beijing Municipal Lawyers Association - Beijing, China
China University of Political Science and Law - Beijing, China
Shanghai Bar Association - Shanghai, China
Office of the Judiciary of Thailand - Bangkok, Thailand
American University of Kosovo - Prishtina, Kosovo
University of Gdańsk - Gdańsk, Poland
University of Wrocław - Wrocław, Poland
School of American Law - Kharkiv, Ukraine
Zhejiang University City College - Hangzhou City, China
2.
Birthdate: (mm/dd/yyyy)
---- Month ----
---- Day ----
---- Year ----
3.
Year of Entering:
4.
Mr. *
Ms. *
5.
Home Address
6.
Office Address:
7.
May we contact you at work?
Yes
No
8.
Gender
* :
Male
Female
9.
State of legal residence * :
Alabama
Alaska
American Samoa
Arizona
Arkansas
Army Postal
California
Colorado
Connecticut
Delaware
District of Columbia
Every State
Fed. States of Micronesia
Florida
Foreign
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Postal Code II
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
10.
Country of citizenship * :
UNITED STATES OF AMERICA
AFGHANISTAN
ALBANIA
ALGERIA
AMERICAN SAMOA
ANDORRA
ANGOLA
ANGUILLA
ANTARCTICA
ANTIGUA AND BARBUDA
ARGENTINA
ARMENIA
ARUBA
ASHMORE AND CARTIER ISLANDS
AUSTRALIA
AUSTRIA
AZERBAIJAN
BAHAMAS
BAHRAIN
BAKER ISLAND
BANGLADESH
BARBADOS
BASSAS DA INDIA
BELARUS
BELGIUM
BELIZE
BENIN
BERMUDA
BHUTAN
BOLIVIA
BOSNIA-HERZEGOVINA
BOTSWANA
BOUVET ISLAND
BRAZIL
BRITISH INDIAN OCEAN TERRITORY
BRITISH VIRGIN ISLANDS
BRUNEI DARUSSALAM
BULGARIA
BURKINA FASO
BURMA
BURUNDI
CAMBODIA
CAMEROON
CANADA
CANAL ZONE
CANTON AND ENDERBURY
CAPE VERDE
CAYMAN ISLANDS
CENTRAL AFRICAN REPUBLIC
CENTRAL AND SOUTHERN LINE ISLANDS
CHAD
CHILE
CHINA
CHRISTMAS ISLAND
CLIPPERTON ISLAND
COCOS (KEELING) ISLANDS
COLOMBIA
COMOROS
COOK ISLANDS
CORAL SEA ISLANDS
COSTA RICA
COTE D'IVOIRE
CROATIA
CUBA
CYPRUS
CZECH REPUBLIC
CZECHOSLOVAKIA
DEMOCRATIC REPUBLIC OF THE CONGO
DEMOCRATIC REPUBLIC OF VIET-NAM
DENMARK
DJIBOUTI
DOMINICA
DOMINICAN REPUBLIC
EAST TIMOR
ECUADOR
EGYPT
EL SALVADOR
EQUATORIAL GUINEA
ERITREA
ESTONIA
ETHIOPIA
EUROPA ISLAND
FALKLAND ISLANDS
FAROE ISLANDS
FEDERATED STATES OF MICRONESIA
FIJI
FINLAND
FRANCE
FRENCH GUIANA
FRENCH POLYNESIA
FRENCH SOUTHERN AND ANTARCTIC LANDS
FRENCH TERRITORY OF AFARS & ISSAS
GABON
GAMBIA
GAZA STRIP
GERMAN DEMOCRATIC REPUBLIC
GERMANY
GERMANYFEDERAL REPUBLIC OF
GHANA
GIBRALTAR
GILBERT AND ELLICE ISLANDS
GILBERT ISLANDS
GLORIOSO ISLANDS
GREECE
GREENLAND
GRENADA
GUADELOUPE
GUAM
GUATEMALA
GUERNSEY
GUINEA
GUINEA-BISSAU
GUYANA
HAITI
HEARD ISLAND AND MCDONALD ISLANDS
HONDURAS
HONG KONG
HOWLAND ISLAND
HUNGARY
ICELAND
INDIA
INDONESIA
IRAN
IRAQ
IRAQ-SAUDI ARABIA NEUTRAL ZONE
IRELAND
ISLE OF MAN
ISRAEL
ISRAEL-JORDAN DEMILITARIZED ZONE
ISRAEL-SYRIA DEMILITARIZED ZONE
ITALY
JAMAICA
JAN MAYEN
JAPAN
JARVIS ISLAND
JERSEY
JOHNSTON ATOLL
JORDAN
JUAN DE NOVA ISLAND
KAZAKHSTAN
KENYA
KINGMAN REEF
KIRIBATI
KUWAIT
KYRGYZSTAN
LAOS
LATVIA
LEBANON
LESOTHO
LIBERIA
LIBYA
LIECHTENSTEIN
LITHUANIA
LUXEMBOURG
MACAO
MACEDONIA
MADAGASCAR
MALAWI
MALAYSIA
MALDIVES
MALI
MALTA
MARSHALL ISLANDS
MARTINIQUE
MAURITANIA
MAURITIUS
MAYOTTE
MEXICO
MIDWAY ISLANDS
MOLDOVA
MONACO
MONGOLIA
MONTENEGRO
MONTSERRAT
MOROCCO
MOZAMBIQUE
NAMIBIA
NAURU
NAVASSA ISLAND
NEPAL
NETHERLANDS
NETHERLANDS ANTILLES
NEUTRAL ZONE
NEW CALEDONIA
NEW ZEALAND
NICARAGUA
NIGER
NIGERIA
NIUE
NORFOLK ISLAND
NORTH KOREA
NORTHERN MARIANA ISLANDS
NORWAY
OMAN
PAKISTAN
PALAU
PALMYRA ATOLL
PANAMA
PAPUA NEW GUINEA
PARACEL ISLANDS
PARAGUAY
PERU
PHILIPPINES
PITCAIRN ISLANDS
POLAND
PORTUGAL
PORTUGUESE TIMOR
PUERTO RICO
QATAR
REPUBLIC OF GEORGIA
REPUBLIC OF THE CONGO
REPUBLIC OF VIET-NAM
REUNION
ROMANIA
RUSSIA
RWANDA
SAINT HELENA
SAINT KITTS AND NEVIS
SAINT LUCIA
SAINT PIERRE AND MIQUELON
SAINT VINCENT AND THE GRENADINES
SAN MARINO
SAO TOME AND PRINCIPE
SAUDI ARABIA
SENEGAL
SERBIA
SERBIA-MONTENEGRO
SEYCHELLES
SIERRA LEONE
SIKKIM
SINGAPORE
SLOVAKIA
SLOVENIA
SOLOMON ISLANDS
SOMALIA
SOUTH AFRICA
SOUTH GEORGIA & SOUTH SANDWICH ISL.
SOUTH KOREA
SOUTHERN RHODESIA
SOUTHERN RHUKYU ISLANDS
SPAIN
SPANISH NORTH AFRICA
SPANISH SAHARA
SPRATLY ISLANDS
SRI LANKA
STATELESS
SUDAN
SURINAME
SVALBARD
SVALBARD AND JAN MAYEN
SWAN ISLANDS
SWAZILAND
SWEDEN
SWITZERLAND
SYRIA
TAIWAN
TAJIKISTAN
TANZANIA
THAILAND
TOGO
TOKELAU
TONGA
TRINIDAD AND TOBAGO
TROMELIN ISLAND
TRUST TERRITORY OF PACIFIC ISLANDS
TUNISIA
TURKEY
TURKMENISTAN
TURKS AND CAICOS ISLANDS
TUVALU
UGANDA
UKRAINE
UNION OF SOVIET SOCIALIST REPUBLICS
UNITED ARAB EMIRATES
UNITED KINGDOM
UNITED STATES
UNITED STATES MISC. PACIFIC ISLANDS
UNKNOWN
URUGUAY
UZBEKISTAN
VANUATU
VATICAN CITY
VENEZUELA
VIETNAM
VIRGIN ISLANDS
WAKE ISLAND
WALLIS AND FUTUNA ISLANDS
WEST BANK
WESTERN SAHARA
WESTERN SAMOA
YEMEN
YEMEN (ADEN)
YEMEN (SANAA)
YUGOSLAVIA
YUGOSLAVIA
ZAMBIA
ZIMBABWE
If not USA, give visa status:
Permanent resident
F1 student
Other visa:
11.
City of birth * :
12.
State of birth (US only):
Alabama
Alaska
American Samoa
Arizona
Arkansas
Army Postal
California
Colorado
Connecticut
Delaware
District of Columbia
Every State
Fed. States of Micronesia
Florida
Foreign
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Postal Code II
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
13.
Country of birth * :
UNITED STATES OF AMERICA
AFGHANISTAN
ALBANIA
ALGERIA
AMERICAN SAMOA
ANDORRA
ANGOLA
ANGUILLA
ANTARCTICA
ANTIGUA AND BARBUDA
ARGENTINA
ARMENIA
ARUBA
ASHMORE AND CARTIER ISLANDS
AUSTRALIA
AUSTRIA
AZERBAIJAN
BAHAMAS
BAHRAIN
BAKER ISLAND
BANGLADESH
BARBADOS
BASSAS DA INDIA
BELARUS
BELGIUM
BELIZE
BENIN
BERMUDA
BHUTAN
BOLIVIA
BOSNIA-HERZEGOVINA
BOTSWANA
BOUVET ISLAND
BRAZIL
BRITISH INDIAN OCEAN TERRITORY
BRITISH VIRGIN ISLANDS
BRUNEI DARUSSALAM
BULGARIA
BURKINA FASO
BURMA
BURUNDI
CAMBODIA
CAMEROON
CANADA
CANAL ZONE
CANTON AND ENDERBURY
CAPE VERDE
CAYMAN ISLANDS
CENTRAL AFRICAN REPUBLIC
CENTRAL AND SOUTHERN LINE ISLANDS
CHAD
CHILE
CHINA
CHRISTMAS ISLAND
CLIPPERTON ISLAND
COCOS (KEELING) ISLANDS
COLOMBIA
COMOROS
COOK ISLANDS
CORAL SEA ISLANDS
COSTA RICA
COTE D'IVOIRE
CROATIA
CUBA
CYPRUS
CZECH REPUBLIC
CZECHOSLOVAKIA
DEMOCRATIC REPUBLIC OF THE CONGO
DEMOCRATIC REPUBLIC OF VIET-NAM
DENMARK
DJIBOUTI
DOMINICA
DOMINICAN REPUBLIC
EAST TIMOR
ECUADOR
EGYPT
EL SALVADOR
EQUATORIAL GUINEA
ERITREA
ESTONIA
ETHIOPIA
EUROPA ISLAND
FALKLAND ISLANDS
FAROE ISLANDS
FEDERATED STATES OF MICRONESIA
FIJI
FINLAND
FRANCE
FRENCH GUIANA
FRENCH POLYNESIA
FRENCH SOUTHERN AND ANTARCTIC LANDS
FRENCH TERRITORY OF AFARS & ISSAS
GABON
GAMBIA
GAZA STRIP
GERMAN DEMOCRATIC REPUBLIC
GERMANY
GERMANYFEDERAL REPUBLIC OF
GHANA
GIBRALTAR
GILBERT AND ELLICE ISLANDS
GILBERT ISLANDS
GLORIOSO ISLANDS
GREECE
GREENLAND
GRENADA
GUADELOUPE
GUAM
GUATEMALA
GUERNSEY
GUINEA
GUINEA-BISSAU
GUYANA
HAITI
HEARD ISLAND AND MCDONALD ISLANDS
HONDURAS
HONG KONG
HOWLAND ISLAND
HUNGARY
ICELAND
INDIA
INDONESIA
IRAN
IRAQ
IRAQ-SAUDI ARABIA NEUTRAL ZONE
IRELAND
ISLE OF MAN
ISRAEL
ISRAEL-JORDAN DEMILITARIZED ZONE
ISRAEL-SYRIA DEMILITARIZED ZONE
ITALY
JAMAICA
JAN MAYEN
JAPAN
JARVIS ISLAND
JERSEY
JOHNSTON ATOLL
JORDAN
JUAN DE NOVA ISLAND
KAZAKHSTAN
KENYA
KINGMAN REEF
KIRIBATI
KUWAIT
KYRGYZSTAN
LAOS
LATVIA
LEBANON
LESOTHO
LIBERIA
LIBYA
LIECHTENSTEIN
LITHUANIA
LUXEMBOURG
MACAO
MACEDONIA
MADAGASCAR
MALAWI
MALAYSIA
MALDIVES
MALI
MALTA
MARSHALL ISLANDS
MARTINIQUE
MAURITANIA
MAURITIUS
MAYOTTE
MEXICO
MIDWAY ISLANDS
MOLDOVA
MONACO
MONGOLIA
MONTENEGRO
MONTSERRAT
MOROCCO
MOZAMBIQUE
NAMIBIA
NAURU
NAVASSA ISLAND
NEPAL
NETHERLANDS
NETHERLANDS ANTILLES
NEUTRAL ZONE
NEW CALEDONIA
NEW ZEALAND
NICARAGUA
NIGER
NIGERIA
NIUE
NORFOLK ISLAND
NORTH KOREA
NORTHERN MARIANA ISLANDS
NORWAY
OMAN
PAKISTAN
PALAU
PALMYRA ATOLL
PANAMA
PAPUA NEW GUINEA
PARACEL ISLANDS
PARAGUAY
PERU
PHILIPPINES
PITCAIRN ISLANDS
POLAND
PORTUGAL
PORTUGUESE TIMOR
PUERTO RICO
QATAR
REPUBLIC OF GEORGIA
REPUBLIC OF THE CONGO
REPUBLIC OF VIET-NAM
REUNION
ROMANIA
RUSSIA
RWANDA
SAINT HELENA
SAINT KITTS AND NEVIS
SAINT LUCIA
SAINT PIERRE AND MIQUELON
SAINT VINCENT AND THE GRENADINES
SAN MARINO
SAO TOME AND PRINCIPE
SAUDI ARABIA
SENEGAL
SERBIA
SERBIA-MONTENEGRO
SEYCHELLES
SIERRA LEONE
SIKKIM
SINGAPORE
SLOVAKIA
SLOVENIA
SOLOMON ISLANDS
SOMALIA
SOUTH AFRICA
SOUTH GEORGIA & SOUTH SANDWICH ISL.
SOUTH KOREA
SOUTHERN RHODESIA
SOUTHERN RHUKYU ISLANDS
SPAIN
SPANISH NORTH AFRICA
SPANISH SAHARA
SPRATLY ISLANDS
SRI LANKA
STATELESS
SUDAN
SURINAME
SVALBARD
SVALBARD AND JAN MAYEN
SWAN ISLANDS
SWAZILAND
SWEDEN
SWITZERLAND
SYRIA
TAIWAN
TAJIKISTAN
TANZANIA
THAILAND
TOGO
TOKELAU
TONGA
TRINIDAD AND TOBAGO
TROMELIN ISLAND
TRUST TERRITORY OF PACIFIC ISLANDS
TUNISIA
TURKEY
TURKMENISTAN
TURKS AND CAICOS ISLANDS
TUVALU
UGANDA
UKRAINE
UNION OF SOVIET SOCIALIST REPUBLICS
UNITED ARAB EMIRATES
UNITED KINGDOM
UNITED STATES
UNITED STATES MISC. PACIFIC ISLANDS
UNKNOWN
URUGUAY
UZBEKISTAN
VANUATU
VATICAN CITY
VENEZUELA
VIETNAM
VIRGIN ISLANDS
WAKE ISLAND
WALLIS AND FUTUNA ISLANDS
WEST BANK
WESTERN SAHARA
WESTERN SAMOA
YEMEN
YEMEN (ADEN)
YEMEN (SANAA)
YUGOSLAVIA
YUGOSLAVIA
ZAMBIA
ZIMBABWE
14.
Are you of Hispanic or Latino Origin? (means a person of Cuban,
Mexican, Puerto Rican, South or Central American, or other Spanish
culture or origin, regardless of race).
Yes
No
14a.
If you wish to be identified with a particular racial or
ethnic group, please check one or more of the
following: *
15.
Next of kin/Contact person in the U.S.
Relationship
15a.
Next of kin/Contact person outside the U.S.
Relationship
QUESTIONS 16-18
Lawyers are held to the highest ethical standards. The
failure to disclose an act or event such as the ones described
below is often more significant, and leads to more serious consequences,
than the act or event itself. Failure to provide truthful
answers, or failure to inform the Office of International Law and Policy
of any changes in your answers, may result in revocation of admission
or disciplinary action by the College of Law. An affirmative
response does not necessarily prejudice your admission to Chicago-Kent.
16.
Have you ever been convicted of, plead guilty or nolo contendre
to, or received a period of supervision for, any offense other than
a minor traffic or parking violation, or is any charge now pending
against you concerning such an offense? (A "minor
traffic violation" is a violation for which only a citation
was issued, e.g. speeding. You must report any other
traffic offense, including any offense in which acting under the
influence of a drug or alcohol was an element of the offense.) You
must disclose each instance regardless of whether a conviction was
reversed, set aside or vacated, or the record sealed or expunged.
Yes
No
If yes, give details below.
17.
Have you ever been dropped, suspended, placed on academic or social
probation or warning, or otherwise disciplined by any college or
university, for any reason?
Yes
No
If yes, give details below.
18.
Have you ever been suspended, placed on probation or warning, or
otherwise disciplined by any professional organization or state
agency charged with reviewing professional conduct or are any charges
or proceedings that could culminate in such sanctions pending?
Yes
No
If yes, give details below.
19.
Do you consider English to be your primary language?
Yes
No
If English is not your primary language, when did you take or when do you
plan to take the Test of English as a Foreign Language?
Date
TOEFL Score
20.
Have you previously applied to Chicago-Kent College of Law?
Yes
No
If yes, in what year?
What was the decision?
21.
To what other law schools have you applied?
22.
Please list in chronological order all high schools, colleges,
universities, graduate and/or professional schools you have attended,
including all part-time or summer programs, whether or not you received
credit or were a candidate for a degree.
23.
In what states and/or countries have you been admitted to practice:
(give year of admission)
24.
Please list any areas of special interest in the law (for example,
intellectual property or criminal law):
25.
List all scholastic or academic honors you have received including
scholarships, fellowships, prizes, honor societies, publications,
etc.
26.
Please list no more than three extracurricular, community, or
professional activities which have been important to you.
Briefly describe each activity and your contribution (including number of
hours per week) to that activity.
27.
Employment record: List (most recent first) full-time, part-time
and summer employment, including military service. (Use a separate
sheet, if necessary, or submit a resume.)
Describe your responsibilities in your current position:
28.
Has any member of your family attended IIT?
Yes
No
Chicago-Kent?
Yes
No If yes, what is this person's name, year of graduation, and
relationship to you?
Name:
Year of Graduation:
Relationship:
29.
References (persons who might be contacted by the law school).
Please furnish the names, addresses, and phone numbers of the two
individuals from whom you have requested recommendations.
APPLICANT'S STATEMENT:
REQUIRED OF ALL APPLICANTS
The Admissions Committee believes that all relevant factors should be
considered when selecting an entering class. You should
therefore write a statement describing yourself and your qualifications,
including the professional goals which you expect to advance by pursuit
of an L.L.M. You may wish to explain or emphasize a particular
part of your transcript or application. You are invited to
inform the Committee of achievements and qualities not otherwise revealed
by the application. Applicants for the LL.M. Program in
International Intellectual Property Law or Financial Services Law should
also state why you are interested in that particular program and why you
believe you are well qualified to undertake specialized study in
International Property Law or Financial Services Law. Attach a
separate sheet if necessary.
I.
I certify, to the best of my knowledge, that all statements submitted
are correct, complete, and my own work, and that I will notify
Chicago-Kent of any changes in the information contained herein arising
prior to my matriculation to the law school (whether or not the Committee
has already acted on my application.)
I understand that failure to supply accurate, complete, and updated
information may result in a filing of Applicant Misconduct with
LSAC, withdrawal of any offer of admission or cancellation of
registration, and may be a violation of the Chicago-Kent College
of Law Code of Conduct and may also jeopardize my eventual admission
to the bar. I understand that this application and
also other records gathered for my admission file are confidential
and will be handled in accordance with the Family Educational
Rights and Privacy Act of 1974 (Buckley Amendment).
I agree: (check box if complying)
II.
If this application for admission is approved, I agree to comply
with all rules and regulations of the law school as published in
the Student Handbook. I also acknowledge that I will
comply with the Chicago-Kent College of Law Code of Conduct.
I agree: (check box if complying)
III.
If admitted to IIT, I hereby authorize the Director of Student Health
at Illinois Institute of Technology, or any physician approved by
the director, to examine me and treat me in cases of emergency when
the Medical Department or the dean has been unable to get in touch
with my parents, guardian, or spouse. (A student who for religious
reasons does not wish to sign this statement should write to the
Director of Admissions. Some churches have forms which
may be used by students requesting exemption from medical provisions.)
I agree: (check box if complying)