Honors and Scholars Program at Clark Atlanta University



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Honors and Scholars Program at Clark Atlanta University

Application and Profile Packet












Tfp:04042017

Date Received __________ (Office Use Only)

Please Type, or Print in Blue or Black Ink Only.

PART I. Personal Profile

Name_________________________________________ 900 # _______________

First Middle Last

Primary E-mail________________________ Secondary E-mail _______________________

Telephone No. ( )___________________ Cell Number ( )___________________

Area Code Number Area Code Number



If you have an on campus housing assignment, please use this information to complete the Local Address portion below. If you are living off campus at an address other than the permanent address listed above please use that information in the Local Address portion.

Local Address _________________________________________________________________

______________________________________________________________________________

City State Zip Code

Birthday ____/____/_____ ____ Male ____ Female

Major/Minor

Major _________________________________________________________________

Minor_________________________________________________________________

Expected Graduation date: Class of _________ Cumulative GPA: __________

NOTE: If you are interested in engineering please do not state engineering as your major. At CAU you must first major in content area (biology, chemistry, computer science, mathematics, or physics). Therefore, state the content area then indicate engineering. See example.

Example: Intended Major Chemistry/Engineering



PART II. Background Information

*Please list the parent or guardian whose contact information is the same as your permanent address listed above.

Mother’s Name_________________________________________________________________

Occupation ______________________________________________________________

Father’s Name _________________________________________________________________

Occupation ______________________________________________________________

Guardian’s Name _______________________________________________________________

Occupation______________________________________________________________

High School Name ______________________________________________________________

__________________________________________________________________

Address

Are you a first generation college student? _____Yes _____No



Unweighted High School Grade Point Average ___________

Cumulative Grade Point Grade Point Average ____________

SAT Score ___________

ACT Score ___________



Part III. Honors, Activities, and Achievements

*Please distinguish between high school and collegiate honors, activities, and achievements.



  1. List honors and accomplishments from the past two years.



  1. List organizations or clubs in which you are a member. Indicate any leadership roles held.



  1. Identify any Advanced Placement courses or International Baccalaureate courses taken.



  1. Identify talents or special interests you have; and highlight any notable experiences or activities of which you have been a part.


Part IV.

Please type and submit the following essay with your completed profile packet

  1. Write a biographical sketch (no more than 1000 words) in a paragraph form. Please include the following information.





Profile packets and essays should be submitted no later than May 1, 2017 by email to Dr. Teri Platt, Interim Director of the Honors and Scholars Program at Clark Atlanta University, at honors@cau.edu. Please contact us if you have questions or trouble submitting your information.


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