Name of Applicant for scholarship:

Last 4 digits of your Student ID: Major: Accounting Economics Finance General Business Administration Management and Administration Marketing Master of Business Administration Address: City: State: ZIP:

E-mail Address: Home Phone: Work Phone: Place of Employment: Approximate number of hours you work per week: If applying for certain scholarships, please specify:

Are you a TOPS recipient? Select YES NO ACT Composite Score:       College Hours Earned: LSUS Overall   LSUS GPA Overall GPA Number of Semesters at LSUS:

Student Achievement and honors:

Organizations in which you hold membership:

Other Scholarships: (Please list any other scholarships you are currently receiving.)

Financial Need: (This information is very relevant for some of the scholarships available; if there are circumstances which affect your receiving a scholarship because of financial need, please include this information.)

All information provided on this application is confidential. Please make every effort to justify your receiving one of these scholarships.