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1of6ApplicationfortheOnlineCertificatePrograminNovelWritingBeforemailingthisapplicationandtheaccompanyingmaterials,youmustregisterforOWA001:OWCCertificateApplicationattheContinuingStudieswebsite:continuingstudies.
stanford.
edu.
PleaseTypeorPrintLastNameFirstNameM.
I.
StreetAddressCityStateZip/MailingCode_CountryTelephoneEmailStudentIDBlogsorWebsitesOthernamesorpseudonymsusedChecklistIhaveregisteredandenrolledinOWA001:OWCCertificateApplicationatcontinuingstudies.
stanford.
eduandpaidtherequired$80applicationfee.
Inasingleenvelope,Iammailingthefollowingfiveforms:ApplicationForm(thispage)ReferencesandEducationPoliciesandHonorCodeStatementofPurpose/PersonalStatement(limit500words)WritingSample(limit6000words)(PleasekeeptheStudentCodeofConductforyourrecords.
)Pleaseaddressyourapplicationto:StanfordContinuingStudiesCertificatePrograminNovelWriting482GalvezMallStanford,CA94305-‐60792of6ReferencesandEducationReferencesAnyonewhocanspeakobjectivelytowardyourqualitiesasapotentialmemberoftheprogramwillmakeagoodreference.
Thislistcouldincludeformerinstructorsinwritingorotherfields,butdoesn'tneedto.
NameRelationshipTelephoneEmailNameRelationshipTelephoneEmailEducationDegreeProgramsDateDegree/ProgramCompletedNameofInstitutionOtherDateNameofCourse(s)CompletedNameofInstitution(PleaselistallcourseworkrelevanttotheCertificateProgram,includingwritingcoursesyouhavealreadytakenwithTheOnlineWriter'sStudiothroughContinuingStudies.
)LanguageProficiencyIfyouareanon-‐nativespeakerofEnglish,pleasebrieflydescribeyourproficiencywiththeApplicantLastNameFirstNameM.
I.
StudentID3of6PoliciesandHonorCodeIunderstandandagreethatImustmaintainaBaveragethroughouttheprogram,weeklyattendanceandeffortwillberequiredineachcourseItake,andthatabsencesorlackofsufficienteffortwillresultinloweredgrades.
IunderstandandagreethatsincetheCertificateProgramisaworkshop-‐basedmodel,Iwillbringrespectandattentiontomycohort'swork.
Ialsounderstandthatitismyresponsibilitytocontributeconstructivelytothecourseenvironment.
Myfailuretomeetthesestandards,aswellasanydisruptiveorhostilebehavioronmypart(asdeterminedbyContinuingStudies),mayresultinimmediateandfullforfeitureofalltuitionandfeespaid.
Ihaveread,andagreetoabideby,theStudentCodeofConductthatappliestoallStanfordContinuingStudiesstudents.
IfurtherunderstandthatfailuretoadheretotheCodeofConductmayresultinmyremovalfromtheCertificateProgram.
IunderstandthatthecurriculumandformatoftheCertificateProgrammaybeadjustedastheprogramevolves.
Iunderstandthattheinstructorofeachcoursewillsetforthhisorherownguidelines,whichIagreetoabideby.
IagreethatIwillsubmitonlyoriginalworkthatIhaveauthored.
Intheinterestofbuildingtrustandcommunity,Iwillusemyrealname.
Ihaveread,andagreetoabideby,thepoliciesandhonorcodeasdetailedontheCertificateProgramwebsite.
I,havereadtheaboveprovisionsdetailingtheCertificateProgramhonorcode.
Iunderstandalltheprovisionscontainedinthisapplication,andagreethatuponadmittancetotheprogramIwillabidebythem.
IalsoagreethataviolationofthehonorcodemayresultintheimmediateandfullforfeitureofalltuitionandfeesI'vepaid,aswellasmyremovalfromtheclassroomandtheprogram.
I,theundersigned,attestthatalltheinformationincludedinthispacketisaccurateandtruthful.
ApplicantLastNameFirstNameM.
I.
StudentIDSignatureDate_4of6StatementofPurpose/PersonalStatementIn500wordsorless,describeyourselfasaperson,student,andpotentialmemberoftheCertificatecohort.
WhydoyouwanttoenrollintheprogramWhatwillyoubringtothecommunityandclassesintheCertificate,andwhatareyourgoalsforyourselfwhileintheprogramFinally,pleasebrieflydescribetheprojectyouwanttopursuewhileintheprogram.
ApplicantLastNameFirstNameM.
I.
StudentID5of6WritingSamplePleaseattachafictionwritingsamplebetween3000and6000words,double-‐spaced.
PleasedoNOTincludeyournameontheactualwritingsample.
Yournameshouldappearnowhereonthewritingsample.
ApplicantLastNameFirstNameM.
I.
StudentID6of6StudentCodeofConductStanfordContinuingStudiesisdedicatedtothemissionofnurturingavibrantlearningcommunity,nourishingthelifeofthemind,andpromotingthepleasuresofintellectualexplorationandexchange.
Studentsinourprogramareexpectedtoconductthemselvesinamannerthatrepresentsthespiritofthismission.
Inaddition,studentsareexpectedtocomplywithallrulesandregulationsputforthbyStanfordUniversity,includingtheUniversity'sFundamentalStandard,whichstatesthat,"StudentsatStanfordareexpectedtoshow…respectfororder,morality,personalhonorandtherightsofothersasisdemandedofgoodcitizens.
FailuretodothiswillbesufficientcauseforremovalfromtheUniversity.
Thefollowingbehaviorwillnotbetoleratedandmayresultinremovalfromourprogram,andfromtheuniversitycampus,aswellasforfeitureofalltuitionandfeespaid.
Unacceptablestudentbehaviorincludes,butisnotlimitedto:Disruptionofteaching,learning,orthefreeflowofideasintheclassroom;Disorderlyconductand/ordisturbingthepeace;Dishonestyand/ormisrepresentingoneself,bothintheclassroomandduringcorrespondencewithinstructors,fellowstudentsandadministrativestaff;RefusaltoadheretoContinuingStudiespoliciesorUniversitypoliciesasstatedinprintedandonlinematerials;Refusaltocomplywithinstructors'parametersforcourserequirementsasstatedinasyllabus,coursedescription,orexplainedintheclassroom;Physicalabuse;intimidation,harassment,threateningbehaviordirectedtowardinstructors,fellowstudentsoradministrativestaff;Unauthorizedattendanceinclassesorpaideventswithoutproperregistration,and/ormisuseofuniversityresources;Sexualmisconductofanykind.
AdmissiontoStanfordContinuingStudiescoursesisdiscretionary.
ContinuingStudiesreservestheright,atitsdiscretion,towithholdregistrationfrom,orrequirewithdrawalfromtheprogramof,anystudentorapplicant.