DOCUMENTS SUBMITTED TO MEET ADMISSIONS AND RESIDENCY REQUIREMENTS BECOME THE PROPERTY OF GSU AND MAY NOT BE RETURNED. TYPE OR PRINT IN DARK INK AND COMPLETE ALL ITEMS.
Have you ever enrolled at GSU? Yes___ No___ If yes, when_________________
When do you plan to enroll at GSU? Fall 19___ Spring 19___ Summer 19___ Summer Only 19___
Legal Name First:__________________ Middle: _____________ Last: ___________________
S.S.#:________________ Birthdate: ________ Sex: _____ Marital Status:___________
Former last names used on transcripts:_______________ Race:_________ Religion:(Optional)__________________
U.S. citizen? Yes___ No___ If no, country of citizenship: ________________ Country of Birth:_______________
VISA Type: ______ TOEFL Score:___ Are you a veteran? Yes__ No__
Street Address:�____________________________ City:____________________ State:____ Zip:________
Years at present address: _____ Phone(include area code):___________________
In case of an emergency, notify Name:____________________ Relationship:________ Phone:__________
Will you be an income tax dependent of your parents and/or guardian during your enrollment at GSU? Yes____ No___ Should this status change, it is your responsibility to notify the Registrar's Office in writing.
Last High School Attended:_______________________________City/State:___________________________
Did you graduate from high school? Yes___ No___ GED___
If yes, graduation Date:_______GPA:_____ACT score:_____SAT score:______
List all colleges attended, including GSU:
COLLEGE:________________________City/State:_____________________________
Dates Attended:_______________Hours/Credits_____
Degree, if any _____________________ Are you currently on suspension?_____
COLLEGE:________________________City/State:_____________________________
Dates Attended:_____________Hours/Credits_____
Degree, if any _____________________ Are you currently on suspension?_____
COLLEGE:________________________City/State:_____________________________
Dates Attended:____________Hours/Credits_____
Degree, if any _____________________ Are you currently on suspension?_____
NOTE: OFFICIAL TRANSCRIPTS FOR ALL PREVIOUS COLLEGE WORK (EXCEPT GSU) MUST BE SUBMITTED. STUDENTS UNDER CURRENT SUSPENSION AND THOSE WHO CANNOT FURNISH OFFICIAL TRANSCRIPTS BECAUSE OF INDEBTEDNESS ARE NOT ELIGIBLE TO ENROLL AT GSU. COLLEGE TRANSFER STUDENTS must have official transcripts from EACH college or university previously attended sent to the Admissions Office, regardless if credits appear on another transcript. An official transcript is defined as one mailed directly from one institution to another. It bears the institution's seal, the signature of the registrar, and the date of issuance. If you have earned less than 12 semester hours, official ACT scores must be submitted. SUMMER ONLY COLLEGE TRANSFER STUDENTS must have a letter of good standing from the Registrar's Office of the institution previously attended.
ALL NEW STUDENTS BORN ON OR AFTER JANUARY 1, 1957 ARE REQUIRED TO SUBMIT PROOF OF IMMUNIZATION FOR MEASLES-RUBELLA-MUMPS (LOUISIANA R.S. 17:170, SCHOOLS OF HIGHER LEARNING) PRIOR TO REGISTRATION. Appropriate form available in Office of Admissions or Foster-Johnson Health Center. |
ALL UNMARRIED FULL-TIME UNDERGRADUATE STUDENTS UNDER TWENTY-ONE YEARS OF AGE, WHETHER EMANCIPATED OR NOT, ARE REQUIRED TO LIVE IN ON-CAMPUS RESIDENCE HALLS UNLESS AN EXEMPTION REQUEST IS FILED WITH AND APPROVED BY THE DIRECTOR OF STUDENT HOUSING. |
Select your intended major from the following list and indicate your selection here:__________________________________
Accounting
Const. Engineering Tech
General Clerical (AA-2yrs)
Mass Communication
Social Science Education Applied Music - Performance
Criminal Justice (4 years)
Geography
Mathematics, General
Social Work
Art
Criminal Justice (AS-2yrs)
Health & Physical Education
Music Education
Sociology
Art Education
Drafting Design
History
Paralegal (AA-2yrs)
Spanish
Auto Engineering Tech
Early Childhood Ed.
Home Economics Education
Paralegal (4 years)
Special Edu.-Elem
Biology
Economics
Hotel/Restaurant Management
Physics
Spec. Edu.-Secondary
Business & Office Education
Elect. Engineering Tech
Industrial Arts Education
Political Science
Spec. Edu.-Early childhood
Chemistry
Elementary Education
Inst./Food Prod. Mgmt.
Political Science (Pre-Law)
Speech Pathology
Child Development (AS-2 yrs)
English Education
Leisure Studies
Pre-Nursing
Theater
Communication/Theatre
English, General
Management
Psychology, General
Undecided (Basic Studies)
Computer Info Sys
French
Mfg Engineering Tech.
Public Administration
Computer Science
French Education
Marketing
Secondary Education
State supported colleges are required to collect documentary evidence of a student's Louisiana residency prior to enrollment. The Office of Admissions reserves the right to determine the validity of the documents submitted and to request additional information in order to comply with state residency requirements.
How long have you lived in Louisiana? Yrs.__Mos.__ Previous state/country of residence? _______________
If you came within the past 2 yrs, why did you move to Louisiana? Education__ Employment__ Job__ Other__
If other, please give a brief explanation:____________________________ DL Number: ________________
State Issued: _____ Exp. Date: ___________ Is this new or renewed? New___ Renewed___
Address on driver's license:_______________________________________________________
Have you been employed in Louisiana in the past 12 months? Yes___ No___
Employer's Name:________________________ Address:_________________________________
Phone: ________________ Dates Employed: _____________ Part-Time___ Full-Time ___
Person upon whom claim is based? Last:________________ First:______________________
Is this person a Parent___ Spouse___ Legal Guardian____ Is this person a citizen? Yes___ No___
Current Address:___________________________________
How long have they lived in Louisiana? Yrs.____ Mos.____
If they moved to LA within the past 2 years, why? Education___ Employment___ Job Transfer___ Other___
If other, please give a brief explanation:__________________________________
If either of your parents (mother and father only or legal guardian)graduated from GSU, please note below:
Name while attending GSU:_______________________ Birth____ S.S.#:_____________ Graduation Date:______
Person on active duty - Last:_____________________ First:____________________
Is this claim for Self___ Spouse___ Legal Guardian___? Home of record (submit documents)__________________
Complete, sign, and return with $10 (Cashier's check or money order-NO CASH) non-refundable application fee ($20 for international students) to the Office of Admissions. If you do not attend GSU for term indicated, a new application and application fee is required. I understand I must meet eligibility requirements of my major as outlined in the GSU catalog. Admission to the University does not constitute admission to a degree program. I understand information submitted herein will be relied upon by college/university officials to determine my status for admission and residency eligibility. I authorize the college/university to verify the information I have provided. I agree to notify the proper officials of the institution of any changes in the information provided. I certify the information on this application is complete and correct. I understand the submission of false information is grounds for rejection of my application, withdrawal of any offer of acceptance, cancellation of enrollment, or appropriate disciplinary action. I certify, if applicable, that I have registered with the Selective Service prior to applying for enrollment:
Grambling State University is an equal opportunity educational institution and will not discriminate due to race, color, creed or religion, national origin, sex, marital or parental status, age, disability, veteran status, or political belief. This policy extends to all programs and activities supported by the University.