APPLICATION FORM

APPLICATION FOR ADMISSION

  • Applicants must be 18 years of age and be a high school graduate or have a high school equivalent.
  • An official high school transcript or DD-214 for Veterans must be submitted with this application form. If a college degree was earned, an official transcript from the college or university where the degree was earned will be accepted in lieu of an official high school transcript.

    Program of Interest:

    First Name

    Middle Name

    Last Name

    Other names appearing on academic records

    Social Security Number

    Date of Birth

    Country of Citizenship

    Permanent Street Address

    City

    State

    Zip Code

    County

    Country

    Phone Number

    Email

    How did you hear about us?

    Other:

    Current or Last Occupation

    Were you laid off from this job?
    YesNo

    Date of last employment

    Emergency Contact Info:

    Name

    Address

    City

    State

    Relationship

    Mobile Number

    Email

    Citizenship Info:

    Please select one
    I am a citizen of the United StatesI am a legal resident of the United States

    My alien registration number is:

    Please attach a copy of your Alien Resident Card

    Veteran Status:

    Were you honorably discharged from the U.S. Armed Forces?
    YesNo

    Date Discharged from U.S. Armed Forces

    Branch

    Upload Identification

    Educational Background:

    List the high school where you earned your high school diploma and all colleges/universities you have attended (if applicable). Upload an additional sheet if necessary. An official transcript from your high school or official transcript from your college (if degree was earned) will need to accompany this application.

    School 1

    Name of School

    Address of School

    Date of Attendance

    Degree or Certification

    School 2

    Name of School

    Address of School

    Date of Attendance

    Degree or Certification

    School 3

    Name of School

    Address of School

    Date of Attendance

    Degree or Certification

    Upload Additional Schools

    Upload Transcript of High School/College

    International Students Only:

    If you are currently living in the U.S. with an International Visa, please indicate the type of visa below (F1 Student Visa, M1 Student Visa, Tourist Visa, etc.).

    Visa Type

    Expiration Date

    Notice: Please note that in order to enroll in any of the programs offered at the Lifton Institute of Media Arts & Sciences, international students must have an F1 Visa. In order to obtain an F1 Visa, you will be asked to provide financial verification that you can cover the costs of tuition and living expenses per Homeland Security requirements. Information about how to obtain an F1 Student Visa is mailed to students upon acceptance into the program.

    Although the Test Of English As A Foreign Language (TOEFL) is not required of international students for enrollment consideration, a copy of scores is appreciated is scores are available. All instruction is conducted in English; therefore applicants should have a strong command of the English Language.

    Have you ever been convicted of a crime?
    YesNo

    If yes, explain number of conviction(s)

    What was the nature of the offense(s) leading to conviction(s)?

    How recently were such offense(s) committed?

    What was the sentence(s) imposed?

    What was the type of rehabilitation?

    LIMS does not discriminate against employees, students, or applicants on the basis of age, color, disability, gender, gender identity, gender expression, national origin, political affiliation, race, religion, sexual orientation, genetic information, veteran status, or any other basis protected by law.

    I declare under penalty of perjury that all information on this form is correct. I understand that falsifying or withholding information required on this form shall constitute grounds for dismissal.

    Digital Required Signature:

    Full Name

    Date

* Required

WHAT ARE YOU WAITING FOR?
REQUEST MORE INFORMATION

    Full Name

    Email

    Phone Number

    Are you a veteran?
    YesNo

    Age

    Program of interest

    How did you hear about us?

    Other:

* Required