APPLICATION FOR ADMISSION
COLLEGE OF BUSINESS
EXECUTIVE MBA PROGRAM
SLU 10735  Hammond, LA 70402
Phone (985) 549-2146  Fax (985) 549-3977
emba@selu.edu  www.selu.edu/Academics/Business/emba/
Application Instructions
1. Application form: Complete and return this form with
a $20 application fee (check or money order, payable to
SLU) to the above address.
2. College transcripts: Please request that one official
transcript be sent from each college or university you
have attended. (A transcript request form is attached).
3. Letters of recommendation: Two letters of
recommendation must be submitted to the Executive
MBA Office in support of your application.
4. Employer Statement: Except in cases of selfemployment, employer must complete the attached
Employer Statement of Recognition of Participation
Form.
Social Security Number
Last Name
Gender
First
Birth Date
Middle
Permanent Address
Home Phone
5. Graduate Management Admission Test: Score
reports must be sent directly from the GMAT
administration to Southeastern Louisiana University.
Please refer to the GMAT Registration Guide for further
information.
6. Proof of Immunization Compliance: State law
requires that all applicants complete this enclosed form.
7. Resume: Include an up-to-date resume with your
application.
8. Original document requirement: Documents sent by
fax cannot be accepted.
9. Interview: Upon submission of your application, an
interview with the director and/or Advisory Committee
may be requested.
Preferred First Name
City
Work Phone
State
Emergency Phone
Zip Code
Email Address
Race/Ethnic Identification (required for federal reporting)
Black, Non-Hispanic
Asian, Pacific Islander
Parish of Residence
Hispanic
American Indian/Alaskan
State of Residence
US Citizen (yes or no)
White, Non-Hispanic
Citizenship (if not US)
Academic Information
List the last high school attended and year of graduation
____________________________________________________________________________________________________
High-school
Year of graduation
List chronologically all colleges previously attended (including SLU), beginning with the college most recently attended.
Dates attended (Month/Year)
Hours
Name of Institution
Degree(s) Earned
Earned
From
To
Undergraduate Degree GPA (estimate)
TOEFL Score (if applicable)
GMAT Score (if available)
Date GMAT taken or anticipated test date
EMBA Program Application for Admission – page 2
Business Information
Present Employer
Beginning Date
Last Name
First
Business Address
Telephone
Immediate Supervisor (including title)
Middle
Preferred First Name
City
Extension
Your Present Title
State
Zip Code
Fax
Beginning Date at Current Title
Description of duties and responsibilities:
Description of products or services furnished by your organization:
Number of people you directly supervise:
Current annual salary (optional):
Professional Certifications:
How many years of full-time business experience (including military) have you had?
Previous employment record (include previous positions with present employer). You may use an additional sheet if
necessary, or attach a resume.
Company
Military Record, if applicable:
Dates Employed
From
To
Positions held (beginning with current)
EMBA Program Application for Admission – page 3
Academic and Professional Enhancement
If you have pursued any other significant non-degree academic or professional programs, please list below.
Dates attended
Course/Enhancement Title
Location
Sponsor/School
From
To
List any major reports, articles, manuals, or projects that you have prepared, researched, or published:
List any community and professional activities that you have completed:
Applicant’s Agreement
If admitted to the Executive MBA program, I agree to follow the program regulations established by Southeastern
Louisiana University, the Graduate School, and the College of Business. I also agree to assume responsibility for
assuring that tuition and fees are paid in a timely manner.
Signature of Applicant
Date
STATEMENT OF RECOGNITION OF PARTICIPATION
COLLEGE OF BUSINESS
EXECUTIVE MBA PROGRAM
SLU 10735  Hammond, LA 70402
Phone (985) 549-2146  Fax (985) 549-3977
emba@selu.edu  www.selu.edu/Academics/Business/emba/
We believe it is important for employers to recognize the commitment and dedication
necessary for a student to successfully complete Southeastern Louisiana University’s Executive
MBA Program. Our estimate of the average time needed by students to meet program
demands is 20 hours per week, including class time and preparation time.
Your signature indicates that you are aware of the applicant’s intent to participate in our
program. Completion of this form does not constitute a letter of reference on behalf of the
candidate.
Applicant’s Name
Name of Company
Employer’s Name (please print or type)
Employer’s Title
Employer’s Signature
Date
TRANSCRIPT REQUEST FORM
COLLEGE OF BUSINESS
EXECUTIVE MBA PROGRAM
SLU 10735  Hammond, LA 70402
Phone (985) 549-2146  Fax (985) 549-3977
emba@selu.edu  www.selu.edu/Academics/Business/emba/
Transcript Request Form For EMBA Students
TO THE APPLICANT: Please type or print, include appropriate fee (if any) and mail directly
to the institution from which you are requesting your transcript.
Full Name:
Last
First
Middle/Former
Social Security or University ID Number:
College/University/Campus:
Dates of attendance:
Degree and year:
Number of copies of transcript requested:
I authorize release of the official transcript of my academic record at the institution named
above for submission to the Southeastern Louisiana University EMBA program.
Signature
Date
TO THE REGISTRAR: This person is applying for the admission to the EMBA Program of
Southeastern Louisiana University. Please forward the requested transcript (s) to:
Executive MBA Program
SLU 10735
Hammond, LA 70402