LSU Austin Alumni Chapter 2010-2011 Returning Student Scholarship Application

$1,000 per year ($500 per semester), non-renewable award for RETURNING Students

Instructions:

1. Please complete all information and return the completed application by March 1st, 2010 to: Jay Dauenhauer, 2508 Enfield Rd. #12, Austin, TX 78703 78750
2. Please attach a current transcript from LSU.
3. Applications received by March 1st will be considered for the upcoming school year.

Required:

Cumulative GPA at LSU, between 3.0-4.0

Are you a current student at LSU? Yes No

Classification? Fresh Soph Junior Senior

Major__________________________ Minor___________________________

Expected Date of Graduation_______________________________

Name: Sex: M F Age: DOB:

Permanent Address:

Street City State Zip

LSU Address:

Street City State Zip

Phone: Email address:

Name of School Currently Attending:

Parent(s) or Legal Guardian(s):

Name Name

Address Address

Phone Phone

Please list all requested information, including the year(s) involved. Please be very specific. You may add additional pages if needed.

Clubs & Organizations while at LSU                                                                             Year

Academic distinctions, honors & awards received while at LSU

Community Service & Volunteering while at LSU

Hobbies, Talents, or Interests not listed above

(Ex. Piano Lessons, youth groups, etc.)

Please list any immediate family members who attended LSU:

Name Relation Years Attended Graduated

Please type and attach a brief (one page or less) statement responding to one of the statements below:

1. Which college courses have affected you most and why?
2. What is a personal challenge which you had to overcome while at LSU, and how did you overcome it?
3. Where do you see yourself in ten years?.

I certify that all information on this application is correct.

Student’s Signature Date