Request edit access
Louisiana Engineering Foundation Scholarship Application
Full Name *
Your answer
University *
Current Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Chapter *
LES Chapters are assigned according to the FIRST THREE digits of your zip code. Chapters and their associated zip codes are listed below. Please select the appropriate chapter of your HOME address, not the address of the university you are attending. If you are not a resident of Louisiana, please select "Non-Resident"
Ethnicity *
Your answer
Citizenship (Country) *
Your answer
Gender *
Email Address *
Your answer
Cell Phone *
Your answer
Present GPA Overall *
Your answer
Engineering Subjects GPA *
Your answer
Anticipated Year of Graduation *
Your answer
Engineering Discipline *
Student Classification *
Legal Residence Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Parent/Guardian Name *
Your answer
Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Father's Occupation *
Your answer
Mother's Occupation *
Your answer
List Names of Dependents living in Parent's Home *
Your answer
High School Attended *
Your answer
Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Year Graduated *
Your answer
Special Honors, Activities and Offices held while in College *
Your answer
Brief Description of Financial Need *
Your answer
List Sources of Income. Ex. Help from Parents, Scholarships, Savings, Loans, etc. Please specify amount of each. *
Your answer
Present Employer and Income, If any. *
Your answer
Other comments you would like us to consider. *
Your answer
I authorize my school officials to release any information related to my academic records to the Louisiana Engineering Society and its chapters. Scholarships are due to the LEF State Office no later than Sunday, December 31, 2017. *
Required
I authorize my school officials to release any information related to my academic records to the Louisiana Engineering Society and its chapters. Scholarships are due to the LEF State Office no later than Sunday, December 31, 2017. *
Required
By entering your full name in the box below, you are effectively providing your signature, indicating that all the information on this form is true and accurate, to the best of your knowledge. *
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms