Name
Last First Middle
SSN or ID#
Permanent Address
Street Address City State Zip Phone#
Local Address
Street Address City State Zip Phone#
Email address
State/Country of Legal Residence
Semester/Year for which waiver is requested (indicate year): Fall (August)
Spring (January) Summer (June)
Please list the extra-curricular activities (organizations, employment, sports, etc.) in which you have been involved for the previous two years.
My parent is a graduate of McNeese State University. Yes No
I am a graduate of McNeese State University. Yes No
I/My Parent is a member of the Armed Forces currently stationed in Louisiana. Yes No
I am married to a Louisiana resident. Yes No
Please indicate the activity (if any) in which you will participate during the semester for which this waiver request is made.
Band
Music
Theater
Co-Ed Cheer Squad
Rodeo
Dance Line (Cowgirl Kickers) Visual Arts Debate
Flag Line
SPURS (Spirit Group)
Please indicate if you will receive any of the following during the semester for which this waiver request is made (circle all that apply).
Athletic Scholarship Graduate Assistantship Codofil Exemption
All forms, test scores, transcripts, and documents for admission must be on file with the Admissions Office for processing of this request. Waiver
notification will be made only after the student has been accepted for admission to the University. Detailed information is available in the McNeese
Catalog; please read the information carefully.
Student Signature Date
Office Use Only
FTF
FT Tfr
Continuing
Re-Admit
Adm Cum GPA
HS GPA Sem GPA
HS Rank Cum Hrs
ACT/SAT Verb Math
Perf Ver
Intvw P T
Toefel
Approved Denied
MAA Group 1 2 3
By
Date
Return completed application to:
McNeese S
tate University Scholarships • Box 92575 • Lake Charles LA 70609 • FAX: 337-475-5592
Special Achievement Undergraduate
Non-Resident Waiver Application
