Online Application

1. Applicant Information

Name (First, Middle, Last):

Class entering: Select One Fall Spring   Year: Select One 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020

Full time   Part time   JD/LLM dual-degree

Gender (Optional. Used for identification purposes only): Male   Female

Date of birth: (Optional. Used for identification purposes only):

Social Security # (Optional. Used for identification purposes only):

Present Mailing Address:

Date Good Until:

Telephone (day): (evening):

Fax:

E-mail:

Permanent mailing address, if different from present mailing address:

LSAT score/date: TOEFL score/date:

Bar membership (s) (state and date):

2. Personal Statement

Please include in your application a personal statement (typed), on separate sheets of 8 1/2" x 11" paper. In this statement please explain why you are interested in doing graduate work in insurance law. In addition, you may wish to draw the attention of the Admissions Committee to a particular part of your record or to particular achievements and qualities not otherwise revealed by this application. Please put your name and Social Security number on each page submitted.

3 Higher Education

Attach a separate page listing all colleges and universities, graduate and professional schools (including any enrollment, however brief, at any law school), stating dates of attendance, degree and major.

4 Occupational Experience

Please enclose a copy of your resume that is current up to the date of your application. It should include present and previous employment, name of employer, type of work, dates of work and telephone number. Indicate any memberships in a Bar Association. If not employed, indicate current full-time activity.

5 List the names of the two people you have asked to write recommendations:

Disciplinary Questions

If the answer to any of the following questions is yes, provide full responses on separate 8 1/2" x 11" sheets of paper, clearly referencing the question. Superficial answers lacking detail will substantially prejudice your application. Please put your name and Social Security number on each page submitted.

Have you ever been subject to disciplinary action or proceedings for academic or personal misconduct at any college or university you have attended?

Have you ever been subject to disciplinary action or proceedings for professional or personal misconduct before any bar to which you have been admitted to practice?

Have you ever been convicted by any court, including General or Special Court Martial, without such conviction being vacated, for a misdemeanor for which the sentence was imprisonment, or for any felony?

Because of the high ethical standards to which lawyers are held, I recognize that the failure to disclose an act or event relevant to my application, particularly those calling into question character, honesty, or integrity, is often more significant, and leads to more serious consequences, than the act or event itself. My failure to provide truthful answers, or to fail to inform immediately the Admissions Committee of any changes to my answers or personal circumstances may result in revocation of admission, disciplinary action or denial of permission to practice law by the State in which I seek admission. I certify that all statements are my own work and that the information provided in this application and all attachments is complete and accurate to the best of my information and belief. I have an ongoing obligation to inform the Admissions Office of any false or misleading statements and any changed circumstances within 30 days of my first notice of such events.

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Signature of Applicant

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Date