Selznick School Certificate Application

Name (Last, First, Middle)

Country

Street address

City

State

Zip code

Country

Street address

City

State

Zip code

Phone

Type of Phone

TOEFL Score (If required):

Citizenship

Other…

Please specify country of citizenship

Type of Visa

Languages

Previous Education

Institution	Start Date	End Date	Degree	Major	GPA
Institution	Start Date	End Date	Degree	Major	GPA
Institution	Start Date	End Date	Degree	Major	GPA
Institution	Start Date	End Date	Degree	Major	GPA

Provide institution name, dates attended, degree received, major, and grade point average

Please enter the contact information for each of your references.

Personal Reference 1

Name

Country

Street address

City

State

Zip code

Phone

Do you waive future access to the letter that this reference provides

Yes

Personal Reference 2

Name

Country

Street address

City

State

Zip code

Phone

Do you waive future access to the letter that this reference provides

Yes

Professional Reference

Name

Country

Street address

City

State

Zip code

Phone

Do you waive future access to the letter that this reference provides

Yes

Cover Letter

One file only.
100 MB limit.
Allowed types: pdf.

Resume / CV

One file only.
100 MB limit.
Allowed types: pdf.

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Selznick School Certificate Application

Personal Reference 1

Personal Reference 2

Professional Reference

Museum Hours
Day	Hours
Tuesday	10 a.m.–5 p.m.
Wednesday	10 a.m.–5 p.m.
Thursday	10 a.m.–5 p.m.
Friday	10 a.m.–5 p.m.
Saturday	10 a.m.–5 p.m.
Sunday	11 a.m.–5 p.m.
Monday	Closed