THE ULM HONORS PROGRAM
PERSONAL DATA
1. Full Name ________________________________________________________________________
2. Mailing Address ____________________________________________________________________
3. Telephone ________________________________
4. CWID ______________________________
5. Birth Date _____________________________
6. Marital Status ________________________
Living on Campus
Yes ________ No _________
HONORS AND ACADEMIC STATUS
Tier
Honors in the Major _________ Honors in the College _________ Honors in the University _________
1. Class Level ___________________________ 2. Major ____________________________________
3. Scholarship(s) applying for (maximum 3) ________________________________________________
4. Overall GPA ________
5. Major GPA ________
6. Number of honor hours presently enrolled ________
7. Number of honors hours completed ________
FINANCIAL DATA
1. Are you currently employed? Yes _________ No _________ Weekly hours of work __________
2. Annual Income __________________
3. Employer ________________________________________________________________________
4. Are you a Veteran? Yes _________
No _________ Are you receiving GI Bill Benefits? _________
5. Are you presently receiving federal or scholarship aid? Yes _________ No _________
Type of Aid
Amount of Aid
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$ _____________ per semester
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$ _____________ per semester
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$ _____________ per semester
_____________________________________________
$ _____________ per semester
List the activities you have participated in honors and non honors, while in college
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Student Signature
Return this application to
ULM Honors Program Director
Brown Hall 309
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Date