Fifth-Year Senior Application
SS #: _________________________________ School year: Fall________ Spring_______
Name: ______________________________________________________________________
Address: ____________________________________________________________________
City: _________________________ Parish: _______________ State: ______ Zip: ________
Home phone: (_____)_________________ Alternate phone: (_____)__________________
Major: _____________________________ Cum. GPA: _________ Earned hrs. __________
How many hours are required for you to complete your degree? _____________________
What LC scholarships or aid do you receive? _____________________________________
Please explain why you need to stay additional semesters at Louisiana College:
Student Signature: ____________________________________Date: ______________
For office use only:
Earned Hours: _______________________________________ Cumulative GPA: ______________________
Amount of Award: $____________________ Fund: _____________________________________________
Awarding Initials: ______________________ Date: __________________________________________
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