INSPIRED
Application Form
All Fields Are Mandatory
Name
Email
Gender
Phone number(DDD-DDD-DDDD)
Phone number Cell
Address Line1
Address Line2
Zipcode
HighSchool
HighSchool Year of Graduation
HighSchool Class Ranking
Current Classification
Graduate
Freshman
Sophomore
Junior
Senior
Scholarships Awarded by LU
Current On Campus Employment
Current Off Campus Employment
Number of CS/CIS courses completed:
Grade Point Average in completed CS/CIS Courses:
Overall Grade Point Average:
Test Scores (SAT/ACT)
US Citizen/Permanent Resident
Yes
No
Race (Check All that apply)
White
Black
Hispanic
Asian
Pacific Islander
American Indian
Other
Are you First person in your family who will get a college degree
Yes
No
Are you elegible for financial assistance
Yes
No
Contact information for three references, two of which are your teachers:
Name
Relationship to Applicant
Email Address
Phone Number
Type the above number