Intent to Enroll and Statement

Science in the Evening (SIE)
Post-Baccalaureate Program Application

  • If further information is required, you will be contacted via email. Upon review, official notification will be sent via e-mail.
  • A Bachelor's Degree is required. If you do not have a Bachelor's Degree, the form will allow a printed version to be generated for special consideration.
  • The non-refundable $75.00 application fee is required at the time of application submission.

Student Information

U.S. Social Security Number

*Leave blank if you do not have a SSN. You will be issued a university student identification number.
Professional/Graduate School are you interested in attending?
*United States Citizen?


*Student Name


Middle Name

* E-mail address:
* Gender
Male Female
* Date of Birth:
- Year:

Permanent Mailing Address

Postal Code:

Current Mailing Address Use Permanent Address

Postal Code:
Home phone number:
Daytime/Mobile phone number:

Race and Ethnicity Data Collection

Colleges and universities are asked by many, including federal and State governments and national surveys to describe the racial/ethnic backgrounds of our students and employees. You should answer both questions.
Are you of Hispanic or Latino origin? Yes No
What is your race? Select one or more of the following categories. Select one or more of the following categories.
Black or African American
American Indian or Alaska Native
Native Hawaiian or Other Pacific Islander

Education Information

Have you ever previously applied for admission to the University of Maryland, College Park?
Please enter your college information below
State City School

Additional Questions

Are you a U.S. armed forces veteran? Please note: This program is not eligible for VA Benefits.
*Are you in good standing at all current and previous institutions and eligible to return, including the University of Maryland?
*Has disciplinary action been initiated or taken against you at any of the institutions attended, including the University of Maryland?
*Have you been charged with, indicted for, pleaded guilty to, or guilty of any criminal offense excluding minor traffic violations?
*Do you wish to be considered for in-state tuition status?
Click here for the Policy on Student Residency Classification.

I certify that I have earned a four-year baccalaureate degree with at least a 2.0 grade point average (on a 4.0 scale). I understand official transcripts must be submitted for admission to the Science in the Evening (SIE). I certify that all information provided on this application is complete and correct. If it is not, I understand that cancellation of admission and registration may result. I agree to abide by the rules, policies and regulations of the University of Maryland. I agree to pay the $75.00 non-refundable application fee which will be assessed regardless of my decision to register. If I am a state of Maryland resident, I must complete the Maryland Residency Classification Information Form. I have read the SIE Web site, found at and understand the registration requirements including the online Math Placement Test (MPT), advising, Medical History & Immunization Record form, SIE Enrollment Policy, as well as the tuition, fees, and payment due information. I understand that upon registration for courses, it is my responsibility to ensure that payment posts to my student account by the SIE payment due dates or risk cancellation and loss of course access and seat(s).

* Signature (name) of applicant for program:
*Date: - Year:

If you have any comments or questions please email:

Office of Extended Studies
University of Maryland
Office of Extended Studies
Suite 0132
Main Administration Building
7901 Regents Drive
College Park MD 20742