Untitled - Lamar State College-Port Arthur
CMrero~~v~:
____________________________________________________________________________
College activiti~ and organizations which you are or have been involved: ________________________________________
Specialhono~r~ived:
_______________________________________________________________________
2. FINANCIAL INFORMATION
What other financial assistance will you be receiving for your education (GRANTS, LOANS, SOCIAL SECURITY, VA, ETC.)?
Are you living with your parents?
0 Y~
0 No
SECfION A L Number living in household and relationship to you: __________________________________________________
2. Total family income (INCLUDING PENSIONS, SOCIAL SECURITY, CHILD SUPPORT, VA, TANF, ETC.).
$,- - - - -
YOUR INCOME $_ _ _ _ __
SECTION B
PARENTS $__________
OTHERS $___________
To comply with state la w. the fo llowing questions are being asked .
Are you related to any member of the Board of Regents of the college or university or its system's boards? Applicable relationships include one of the following - (Circle One) Y N
1. Regent's - spouse, spouse's child, spouse's parent, child's spouse, parent's spouse
Y N
2. Regent's - spouse's brother or sister, spouse's grandparent, spouse's grandchild, brother or sister's spouse, grandparent's spouse, grandchild's spouse
Y N
3. Regent's - parent, daughter, son
Y N 4. Regent's - brother, sister, grandparent, grandchild Y N 5 . Regent's - great-grandparent, great-grandchild, uncle or aunt (brother or sister of parent), nephew or niece (son or daughter of brother or sister)
3.EMPLOYMrnNTSTATUS Are you currently employed?
0 Yes
0 No
Part or full-time? _ _ _ _ __ _ _ _ _ __ _ _
Temporary or permanent? _ _ _ _ _ _ _ _ _ __ _ __ _
Place of employment:
Address:_ _ __ _ _ _ _ _ _ _ _ _ _ __
Street
Zip Code
City
4. BRIEFLY DESCRIBE ANY SPECIAL CIRCUMSTANCES WlDCH SHOULD BE CONSIDERED IN DETERMINING YOUR NEED FOR A SCHOLARSmP:
YOU MAY AITACH ADDmONAL PAGES IF NECESSARY.
s.
REFERENCES A. Name Address City
State
Zip
State
Zip
State
Zip
Phone.
B. Name Address City Phone.
C. Name Address City Phone
*** 00 NOT USE RELATIVES' NAMES AS REFERENCES. ***
STUDENTmGNATURE___________________________________________
DAT~E
_____________
FOR HIGH SCHOOL COUNSELOR'S USE ONLY
RECOMMENDED BY:
TITLE OR POSITION: _ _ _ _ _ _ _ _ _ __ _ __
GRADE POINT AVERAGE AND CLASS RANK: _ _ _ _ _ _ _ __ _ _ __ _ _ _ _ _ _ _ _ _ _ __ COMMENTS:_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _____________
FOR ADMISSIONS ADVISOR'S USE ONLY
REMARKS:_______________________________________________ _ _ __ _ __
IF YOU HAVE ANY QUESTIONS, PLEASE CONTACT
ALLISON WRIGHT, AUBRY BOONE, OR LAWANDA BROWN AT
LAMAR STATE COLLEGE-PORT ARTHUR
PHONE: 984-6186 OR 1-800-477-5872
****
NOTES
****
YOU MUST SUBMIT HIGH SCHOOL AND ANY COLLEGE TRANSCRIPTS WITH THIS APPLICATION (IF APPLICABLE: GED OR SAT SCORES). THE HIGH SCHOOL FOUNDATION SCHOLARSHIP DEADLINE IS APRIL 1. APPLICATIONS RECEIVED BEFORE APRIL 1 WILL BE GIVEN FIRST PRIORITY. THE DEADLINE FOR LAMAR STATE COLLEGE-PORT ARTHUR SCHOLARSHIPS IS JUNE 15. ALL SCHOLARSHIP RECIPIENTS ARE ASSUMED TO HAVE FULL·TIME STATUS ON THE PORT ARTHUR CAMPUS WITH A MINIMUM GRADE POINT AVERAGE OF 2.5 OR OTHERWISE SPECIFIED BY SCHOLARSHIP DONOR. FAILURE TO COMPLETE ALL APPROPRIATE BLANKS MAY AFFECT YOUR SELECTION AS A SCHOLARSHIP RECIPIENT.
Lamar State College-Port Arthur is an equal opportunity/affirmative action educational institution and employer. Students, faculty, and staff members are selected without regard to their race, color, creed, sex, age, handicap or national origin, consistent with the Assurance of Compliance with Title VI of the Civil Rights Act of 1964; Executive Order 11246 as issued and amended; Title IX of the Education Amendments of 1972, as amended; Section 504 of the Rehabilitation Act of 1973. Inquiries concerning application of these regulations may be referred to the Vice President for Academic Affairs. No. 470/3M/9-()()
____________________________________________________________________________
College activiti~ and organizations which you are or have been involved: ________________________________________
Specialhono~r~ived:
_______________________________________________________________________
2. FINANCIAL INFORMATION
What other financial assistance will you be receiving for your education (GRANTS, LOANS, SOCIAL SECURITY, VA, ETC.)?
Are you living with your parents?
0 Y~
0 No
SECfION A L Number living in household and relationship to you: __________________________________________________
2. Total family income (INCLUDING PENSIONS, SOCIAL SECURITY, CHILD SUPPORT, VA, TANF, ETC.).
$,- - - - -
YOUR INCOME $_ _ _ _ __
SECTION B
PARENTS $__________
OTHERS $___________
To comply with state la w. the fo llowing questions are being asked .
Are you related to any member of the Board of Regents of the college or university or its system's boards? Applicable relationships include one of the following - (Circle One) Y N
1. Regent's - spouse, spouse's child, spouse's parent, child's spouse, parent's spouse
Y N
2. Regent's - spouse's brother or sister, spouse's grandparent, spouse's grandchild, brother or sister's spouse, grandparent's spouse, grandchild's spouse
Y N
3. Regent's - parent, daughter, son
Y N 4. Regent's - brother, sister, grandparent, grandchild Y N 5 . Regent's - great-grandparent, great-grandchild, uncle or aunt (brother or sister of parent), nephew or niece (son or daughter of brother or sister)
3.EMPLOYMrnNTSTATUS Are you currently employed?
0 Yes
0 No
Part or full-time? _ _ _ _ __ _ _ _ _ __ _ _
Temporary or permanent? _ _ _ _ _ _ _ _ _ __ _ __ _
Place of employment:
Address:_ _ __ _ _ _ _ _ _ _ _ _ _ __
Street
Zip Code
City
4. BRIEFLY DESCRIBE ANY SPECIAL CIRCUMSTANCES WlDCH SHOULD BE CONSIDERED IN DETERMINING YOUR NEED FOR A SCHOLARSmP:
YOU MAY AITACH ADDmONAL PAGES IF NECESSARY.
s.
REFERENCES A. Name Address City
State
Zip
State
Zip
State
Zip
Phone.
B. Name Address City Phone.
C. Name Address City Phone
*** 00 NOT USE RELATIVES' NAMES AS REFERENCES. ***
STUDENTmGNATURE___________________________________________
DAT~E
_____________
FOR HIGH SCHOOL COUNSELOR'S USE ONLY
RECOMMENDED BY:
TITLE OR POSITION: _ _ _ _ _ _ _ _ _ __ _ __
GRADE POINT AVERAGE AND CLASS RANK: _ _ _ _ _ _ _ __ _ _ __ _ _ _ _ _ _ _ _ _ _ __ COMMENTS:_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _____________
FOR ADMISSIONS ADVISOR'S USE ONLY
REMARKS:_______________________________________________ _ _ __ _ __
IF YOU HAVE ANY QUESTIONS, PLEASE CONTACT
ALLISON WRIGHT, AUBRY BOONE, OR LAWANDA BROWN AT
LAMAR STATE COLLEGE-PORT ARTHUR
PHONE: 984-6186 OR 1-800-477-5872
****
NOTES
****
YOU MUST SUBMIT HIGH SCHOOL AND ANY COLLEGE TRANSCRIPTS WITH THIS APPLICATION (IF APPLICABLE: GED OR SAT SCORES). THE HIGH SCHOOL FOUNDATION SCHOLARSHIP DEADLINE IS APRIL 1. APPLICATIONS RECEIVED BEFORE APRIL 1 WILL BE GIVEN FIRST PRIORITY. THE DEADLINE FOR LAMAR STATE COLLEGE-PORT ARTHUR SCHOLARSHIPS IS JUNE 15. ALL SCHOLARSHIP RECIPIENTS ARE ASSUMED TO HAVE FULL·TIME STATUS ON THE PORT ARTHUR CAMPUS WITH A MINIMUM GRADE POINT AVERAGE OF 2.5 OR OTHERWISE SPECIFIED BY SCHOLARSHIP DONOR. FAILURE TO COMPLETE ALL APPROPRIATE BLANKS MAY AFFECT YOUR SELECTION AS A SCHOLARSHIP RECIPIENT.
Lamar State College-Port Arthur is an equal opportunity/affirmative action educational institution and employer. Students, faculty, and staff members are selected without regard to their race, color, creed, sex, age, handicap or national origin, consistent with the Assurance of Compliance with Title VI of the Civil Rights Act of 1964; Executive Order 11246 as issued and amended; Title IX of the Education Amendments of 1972, as amended; Section 504 of the Rehabilitation Act of 1973. Inquiries concerning application of these regulations may be referred to the Vice President for Academic Affairs. No. 470/3M/9-()()
