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Honors Program Application Form

Students with less than 30 hours college credit

First Name
Last Name   MI
Address
City State Zip
Phone ( )   LakerID#

email:

HIGH SCHOOL INFORMATION 
School
Year of Graduation** High School GPA*

SAT*       
Total    Verbal   Math

ACT*
Composite      English         Math
Science         Reading 
 

REFERENCES

1. Name
  Title
  Address
  Phone

 

2. Name
  Title
  Address
  Phone

 

3. Name
  Title
  Address
  Phone

COLLEGE INFORMATION

When did you apply for admission to Clayton State University? 
I have received acceptance.
I have attended another college or university.
     If yes, indicate institution
     Number of hours completed* Qtr/Sem, GPA
* Official records will be used when Clayton State University receives them. Please enter here for convenient reference.

SCHOOL AND COMMUNITY ACTIVITIES

Please indicate school & community activities; your role, office, etc.; and year:

1.

2.

3.

4.

5.

I have or expect to earn AP credit.
      If yes, please indicate

ESSAY

Why do you want to be in the Honors Program at Clayton State University? Be sure to address the following points: (a) describe what you can contribute to the Clayton State University Honors Program (b) explain how you think the program will benefit you.

 

FOR MORE INFORMATION CONTACT:

Adam Tate
Honors Program Director, (678) 466-4809
e-mail AdamTate@clayton.edu

 

This page updated on 10/10/2007