APPLICATION FOR THE MARYLAND TRANSFER ADVANTAGE PROGRAM

OR UNIVERSITIES AT SHADY GROVE TERP TRANSFER PARTNERSHIP

Thank you for applying to one of our transfer programs! As we continue our efforts to ensure a more sustainable future, the university
will no longer accept paper applications for these programs. You may use this printer-friendly version to review your answers or to save
a copy of your application for your records, but do not mail it to our office. Please submit the application online.

Keep in mind that sections of the applications are presented dynamically according to the information required from each applicant.
You may find that some sections below are not required of you and as such, will be blank.

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Name: Meade Henry

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Last Name (family name) First (given name) Middle Name Suffix

Former name (if any):

Last Name First Name

U.S. Social Security Number:

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579-27-5224
For more information on the University of Maryland policy on the collection, use and protection of ID numbers, please
visit www.president.umd.edu/policies/docs/vi_2600A.pdf.

PROGRAM SELECTION
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For which program are you applying? MTAP- Maryland Transfer Advantage Program

CONTACT INFORMATION
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Email Address: henry.meade@gmail.com

Example: abc@def.com
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Email Address:
Example: abc@def.com
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Permanent Mailing Address:

Address 1: 10212 Kensington Parkway

Address 2:

City: Kensington State: Maryland ZIP: 20895

Country: United States

Telephone:
Home Phone: (301) 946-8954

DEMOGRAPHIC INFORMATION
Date of Birth: 06/04/1996
MM/DD/YYYY

Gender: Male
Female

Race/Ethnicity: White
American Indian or Alaska Native
Black or African-American Native Hawaiian or Other Pacific Islander
Asian

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Name: Henry Meade _________ Birthdate: 06/04/1996

Citizenship or Visa Type:

Citizen of the United States Asylee
Permanent Resident of the Asylum Applicant
United States I currently hold a visa with
Pending Permanent Resident type A-R or T-X.
of the United States None of the above.
Refugee

PROGRAM INFORMATION- MARYLAND TRANSFER ADVANTAGE PROGRAM

High School Information
Walter Johnson High School Bethesda
_________________________ Maryland
______________

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Secondary/High School City State

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United States
_____________________________ 210912
__________________ Dates of Attendance: 06/2014
___________ ___________
Country College Board Code From (MM/YYYY) Through (MM/YYYY)

Current College Information

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The MTAP admission process is a collaborative one between the community college and the MTAP Program; all applicants are subject to
a joint review by the community college and the university prior to a final decision of admission into the MTAP Program.

Community College attending or plan to attend: Anne Arundel Community College

College of Southern Maryland
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Montgomery College
Prince George's Community College
City: ___________________________
Rockville

State: ___________________________
Maryland
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Country ___________________________
United States
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Current credits enrolled: _______

7

Total credits earned: _______

21
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Cumulative GPA: ______

2.3

Transfer Information
Area of academic interest: __________________________________________________
STEM

Date of anticipated transfer to the University of Maryland: _____________________

Spring 2017

Are you a Post-Baccalaureate student? Yes

No

I give permission to my community college to release my final academic transcript.

With MTAP I can achieve many lifelong goals.

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Name: Henry Meade _________ Birthdate: 06/04/1996

MTAP Statement
Please attach or insert a statement responding to the question: Why are you interested in participating in the Maryland Transfer
Advantage Program?
With MTAP I can achieve many lifelong goals.

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Name: Henry Meade _________ Birthdate: 06/04/1996

PROGRAM INFORMATION- UNIVERSITIES AT SHADY GROVE TERP TRANSFER PARTNERSHIP

High School Information
Walter Johnson High School _________________________
Bethesda ______________
Maryland

Secondary/High School City State

_____________________________
United States __________________
210912 Dates of Attendance: ___________
06/2014 ___________
Country College Board Code From (MM/YYYY) Through (MM/YYYY)

Current College Information

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Montgomery College M Number: ___________________________

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Primary Montgomery College Campus: Germantown
Rockville
Takoma Park/Silver Spring

Current GPA (Cumulative): _______

Number of credits completed to date:
Transfer Information
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_______

Program of interest with USG Terp Transfer Partnership: Biological Sciences

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Communication
Criminology and Criminal Justice
Anticipated Semester of Transfer: _____________________
I give permission to Montgomery College to release my final academic record.
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I understand there will be an interview required for admittance into the USG Terp Transfer Partnership program.
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Name: Henry Meade _________ Birthdate: 06/04/1996

USGTTP Statement
Please attach or insert a statement briefly describing your academic goals and why you wish to complete this program of interest at the
Universities at Shady Grove campus.

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Name: Henry Meade _________ Birthdate: 06/04/1996

ADDITIONAL INFORMATION

9. How did you learn about this program? _____________________________________________________

MC faculty or staff member

10. Are you a first generation college student? Yes

No

HONOR STATEMENT
I certify that the information on this application is complete and correct. If it is not, I understand cancellation of participation may result.

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Henry Meade
_________________________________________________________ 06/04/1996
_______________________________________________
SIGNATURE OF APPLICANT DATE

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Name: Henry Meade _________ Birthdate: 06/04/1996

NONDISCRIMINATION POLICY
The University of Maryland is an equal opportunity institution with respect to both education and employment. The university does
not discriminate on the basis of race, color, religion, national origin, sex, age, or handicap in admission or access to, treatment or
employment in, its programs and activities as required by federal (Title VI, Title IX, Section 504) and state laws and regulations.
Inquiries regarding compliance with Title VI of the Civil Rights Act of 1964, as amended, Title IX of the 1972 Educational
Amendments, Section 504 of the Rehabilitation Act of 1973, or related legal requirements should be directed to: Director, Office of
Diversity and Inclusion, 1130 Shriver Laboratory, East Wing, University of Maryland, College Park, MD 20742. Telephone:
301.405.2838. Online: www.odi.umd.edu.

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Inquiries concerning the application of Section 504 and part 34 of the C.F.R. to the University of Maryland, College Park may be
directed to: Director, Disability Support Service, 0126 Shoemaker Hall, University of Maryland, College Park, MD 20742. Telephone:

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301.314.7682 or 301.314.7683 (TTY).

In addition to the universitys statement of compliance with federal and state laws, the University Code on Equity, Diversity and
Inclusion notes that the University of Maryland affirms its commitments to a policy of eliminating discrimination of the basis of race,
color, creed, sex, sexual orientation, marital status, personal appearance, age, national origin, political affiliation, physical or mental

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disability, or on the basis of the exercise of rights secured by the First Amendment of the United States Constitution.
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