scholars program


Lawrence Tech Scholars Application
College of Arts & Sciences

1.

Banner ID:


2.

Current Semester/Year:


3.

Name:
Last, First, Middle


4.

Local Address:
Residence Hall and unit number, or local address (street, city, state, zip)


5.

Local Phone:


6.

Email Address:


7.

Permanent Address:
Street, city, state, zip


8.

Permanent Phone:


9.

Semester/Year Admitted to LTU:


10.

School most recently attended prior to Lawrence Tech (high school or other college):
Name, city


11.

Prior GPA:


12.

Lawrence Tech GPA:


13.

Intended Major(s):


14.

Career Goal:


15.

Do/will you work while attending school?
Yes
No

16.

If yes, how many hours will you work per week?


17.

Would you like to be considered for the Summer Connections Program?
*For information on Summer Connections see brochure or scholars website at ltu.edu/scholars
Yes
No

18.

Please list the courses you are currently taking:
At LTU, at another college, or in high school


19.

Please list the courses you took last semester:
At LTU, at another college, or in high school