Personal Information Form - Computer Professionals Program at MIU

Personal Information Form

Please fill out this form and click the “Submit” button at the bottom of the page. If the form doesn’t submit, please check that you filled in all the required fields.

Note: False or misleading information in your application may result in dismissal from the program.

* Indicates required field
GENERAL INFORMATION
Your Application ID*
Your Complete Name, including all middle names*
For official documents, please indicate how you would fill out the following:
Your Given Name (First Name)*
Your Surname (Family name or Last name)*
Mailing Address to send acceptance package to (please do not use a Post Box number)
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Daytime Phone*
Evening Phone
Fax
Email Address*
Skype
Gender*
- Male
- Female
Marital Status
- Married
- Unmarried
Birthday*
DD slash MM slash YYYY
City of Birth*
Country of Birth*
CITIZENSHIP
Are you a US citizen?*
- Yes
- No
Country of Citizenship*
If you are not a U.S. citizen, do you have U. S. permanent resident status?*
If you are not a U.S. citizen or permanent resident, do you have a visa to be in the U.S.?*
Type of Visa (required if you have a visa)
Expiration Date of Visa (required if you have a visa)
MM slash DD slash YYYY
Native Language*
Other Fluent Languages
Have you been instructed in the Transcendental Meditation technique?
PERSONAL INFORMATION
Have you ever been involved in any techniques for self-development?
Names / Type of Program
Teacher and/or Organization
From
DD slash MM slash YYYY
To
DD slash MM slash YYYY
Do you use non-prescription drugs, such as hallucinogens, marijuana, amphetamines, barbiturates, narcotics, etc.?
If yes, please list type of drug:
Quantity/Frequency
Date Used From
DD slash MM slash YYYY
Date Used To
DD slash MM slash YYYY
List Another
Type of drug
Quantity/Frequency
Date Used From
DD slash MM slash YYYY
Date Used To
DD slash MM slash YYYY
EMERGENCY CONTACT
Name*
First Last
Relationship*
Address*
Phone*
ESSAYS
Please write an essay on each of the following questions. The minimum length for each essay is 200 words. If either essay does not meet this requirement, you will be asked to write the essay again.
What goals do you have for yourself, including both personal and professionals goals?*
What is your understanding of why the Transcendental Meditation technique is part of the curriculum at MIU? (See https://compro.miu.edu/student-life/personal-development/ and http://www.tm.org.) (Please write this in your own words. Do not copy/paste information from the website or any other document.)*
CERTIFICATION
I certify that all statements made by me in applying for admission to Maharishi University of Management are complete and true. I realize that false statements may be grounds for denial of admission or dismissal from the university. “Your printed name counts as your signature.”
Signature*
Date*
DD slash MM slash YYYY