SCHOLARSHIP APPLICATION

School of Forestry

1. Name _______________________________________________________________________

Last First MI

2. Home Address ________________________________________________________________

Number & Street

______________________________________________________________________________

City State Zip

3. Phone _______________________________________________________________________

4. E-mail Address _______________________________________________________________

5. Social Security # ______________________________________________________________

6. Are you a Louisiana resident? Yes No ___

7. I am currently a: high school senior , college freshman , college sophomore ,

college junior , college senior , transfer from another university

9. Current grade point average: (Please attach an unofficial copy of your transcript)

Wildlife_____

II. Education Background

1. High School

Address

2. Graduation Date Rank in Class out of ___________________

3. Composite ACT Score High school GPA College GPA ________

III. Activities Information

1. List organizations that you belong to or have belonged to and any offices you have held. (Include such groups as church, 4-H, scouts, clubs, etc.)

a.

b.

c.

d.

e.

2. List activities in which you have been engaged in high school or college such as athletics, play, public speaking, contests, music, etc., and any honors you may have won.

a.

b.

c.

d.

e.

IV. What are your personal goals? (In your own words)

V. Signature

1. I hereby state that the information submitted herewith is true and correct to the best of my knowledge.

Signature _______________________________________ Date ________________________

2. If selected for a scholarship in the School of Forestry, I agree to notify the donors of my acceptance and appreciation. (The School of Forestry will provide you with the appropriate names and addresses of donors).

Signature _______________________________________ Date ________________________

Mail or return to: Chairman, Scholarship Committee

School of Forestry

Louisiana Tech University

P.O. Box 10138

Ruston, LA 71272