Application For Admission College of Business

Social Security Number Gender Birth Date

Last Name First Middle Preferred First Name

Permanent Address City State Zip Code

Home Phone Work Phone Emergency Phone Email Address

Race/Ethnic Identification (required for federal reporting)
	Black, Non-Hispanic		Hispanic		White, Non-Hispanic
	Asian, Pacific Islander		American Indian/Alaskan

Parish of Residence State of Residence US Citizen (yes or no) Citizenship (if not US)

Academic Information
List the last high school attended and year of graduation

____________________________________________________________________________________________________

High-school Year of graduation
List chronologically all colleges previously attended (including SLU), beginning with the college most recently attended.

Name of Institution	Dates attended (Month/Year)		Degree(s) Earned	Hours Earned
	From	To

Undergraduate Degree GPA (estimate) TOEFL Score (if applicable)

GMAT Score (if available) Date GMAT taken or anticipated test date

EMBA Program Application for Admission – page 2

Business Information

Present Employer Beginning Date Immediate Supervisor (including title)

Last Name First Middle Preferred First Name

Business Address City State Zip Code

Telephone Extension Fax

Your Present Title Beginning Date at Current Title

Description of duties and responsibilities:

Description of products or services furnished by your organization:

Number of people you directly supervise: Current annual salary (optional):

Professional Certifications:

How many years of full-time business experience (including military) have you had?
Previous employment record (include previous positions with present employer). You may use an additional sheet if necessary, or attach a resume.

Company	Dates Employed		Positions held (beginning with current)
	From	To

Military Record, if applicable:

EMBA Program Application for Admission – page 3
Academic and Professional Enhancement
If you have pursued any other significant non-degree academic or professional programs, please list below.

Course/Enhancement Title	Dates attended		Location	Sponsor/School
	From	To

List any major reports, articles, manuals, or projects that you have prepared, researched, or published:

List any community and professional activities that you have completed:

Applicant’s Agreement
If admitted to the Executive MBA program, I agree to follow the program regulations established by Southeastern Louisiana University, the Graduate School, and the College of Business. I also agree to assume responsibility for assuring that tuition and fees are paid in a timely manner.

Signature of Applicant Date

Statement of Recognition of Participation

College of Business

Executive MBA Program
SLU 10735  Hammond, LA 70402

Phone (985) 549-2146  Fax (985) 549-3977

emba@selu.edu  www.selu.edu/Academics/Business/emba/

We believe it is important for employers to recognize the commitment and dedication necessary for a student to successfully complete Southeastern Louisiana University’s Executive MBA Program. Our estimate of the average time needed by students to meet program demands is 20 hours per week, including class time and preparation time.

Your signature indicates that you are aware of the applicant’s intent to participate in our program. Completion of this form does not constitute a letter of reference on behalf of the candidate.

Applicant’s Name

Name of Company

Employer’s Name (please print or type)

Employer’s Title

Employer’s Signature Date

Transcript Request Form

College of Business

Executive MBA Program
SLU 10735  Hammond, LA 70402

Phone (985) 549-2146  Fax (985) 549-3977

emba@selu.edu  www.selu.edu/Academics/Business/emba/

Transcript Request Form For EMBA Students

TO THE APPLICANT: Please type or print, include appropriate fee (if any) and mail directly to the institution from which you are requesting your transcript.

Full Name:

Last First Middle/Former

Social Security or University ID Number:

College/University/Campus:

Dates of attendance:

Degree and year:

Number of copies of transcript requested:

I authorize release of the official transcript of my academic record at the institution named above for submission to the Southeastern Louisiana University EMBA program.

Signature Date

TO THE REGISTRAR: This person is applying for the admission to the EMBA Program of Southeastern Louisiana University. Please forward the requested transcript (s) to:
Executive MBA Program

SLU 10735

Hammond, LA 70402

Directory: acad research -> programs
programs -> Social Work Program Center for Student Excellence Advising Manual Table of Contents Information: Pages
acad research -> Student handbook
acad research -> Educational Computing gpa 0
acad research -> Education ph. D ohio State University, Industrial & Organizational Psychology ma vanderbilt University, Experimental Psychology ba florida State University, Psychology Experience