Personal Data Sheet (Form 1)

Please type or print LEGIBLY. Information from this sheet will be transferred to computer disk by

department. Submit this form in the first two weeks of you first semester at LSU. Attach a current C.V.

DATE: ______________________________

Name: ______________________________________________________________________________

Address: ____________________________________________________________________________

Street Address City State Zip

Phone Number: ( ) ______________________ (home) / ( ) _____________________ (other)

E-mail Address: ______________________________________________________________________

Degree Sought: _______________________________________________________________________

Major: ______________________________________________________________________________

Minor: _____________________________________________________________________________

Principal Interests: ____________________________________________________________________

____________________________________________________________________________________

Committee Members: __________________________________________________________________

____________________________________________________________________________________

Skills: ______________________________________________________________________________

____________________________________________________________________________________

Language: ___________________________________________________________________________

Computer (be specific—programming ability, familiarity with certain software/hardware, etc.): _______

____________________________________________________________________________________

____________________________________________________________________________________

Field Experience: _____________________________________________________________________

Teaching: ___________________________________________________________________________

Area Studies: ________________________________________________________________________

Other special skills / talents: ____________________________________________________________

____________________________________________________________________________________

Current semester course work:

Course Number Course Name Meeting Hours Instructor

___________ __________ ______________ _____ _______

 School Form 1 (SF 1) School Register
(This replaces Form 1, Master List & STS Form 2-Family Background and Profile)

R
e
Di
gi Di
vi
Sc o str
si
ho n ict
on
ol VI
ID II
S
Sch Gr e
Sch ad
ool c
ool e
Na Le ti
Year
me vel o
n
B A GU C
R
I G AR o
I E
R E DIA nt
P M
T a M PARENT N a
( ADDRESS A
H s O S (If ct
E R
S D o T not N
NAME t K
e A f H R Par u
(Last h S
x T 1 E E ent) m
L Name, n
( E s R LI H Fat Mot R b (
R First i M
M ( t T GI o B her' her' e er P
N Name, c u
/ m F O O u a s s l of l
Middle G ni
F m r N N s r Pr Na Mai N a P e
Name) r ci
) / i G e a ovi me den a ti ar a
o p
d d U # n nc (La Na mo e s
u al
d a E / g e st me e n nt e
p it
/ y S a Na (La - o r
) y/
y J t y me, st s r e
C
y u r Fir Na h G f
y n e it st me, i u e
y e e y Na Firs p ar r
) t me, t di t
/ Mid Na a o
S dle me, n t
i Na Mid h
t me) dle e
i Na l
o me) e
/ g
P e
u n
r d
o o
k n
l
a
s
t
p
a
g
e
)
List and Code of Indicators
under REMARKS column
R R
e e
q q
u u
I ir ir Cer
n e e Pre tifie
d d d R par d
C C E
B E ed Cor
i I I G
o o IS o o by: rect
c n n T
d d E SS
:
a f f R
YY
e e E
t o o D

o r r
r m m
a a
ti ti
o o
n n
T Name of CCT
r Public (P) Control/r
a T Private C eference M
A
n / (PR) C number L
s O School & T& E
f Effectivity Effectivit
e Date y Date
rr
e
d
O
u
t
N (Sign (Signa
ature ture of
a of Schoo
m Advis l Head
er over
e over Printe
of Print d
ed Name
T s Nam )
r c e)
a h
Name of
n o
Public (P) F
s ol
T Private B E
f la M
/ (PR) / A
e st
I School & A L
rr at E
Effectivity
e te
Date
d n
I d
N e
d
&
Y
e
ar
D
r S
Reason T
o D Lp O
and
p R We T
Effectivity A
p P D ci
Date L
e fy
d
 S
p
e B B
ci o o
L
fy S S
a
L Y Y
t
e D D
e
v a a
E Reason
el t t
n (Enrollmen A
L & e e
r t beyond C
E E : :
o 1st Friday L
ff E E
ll of June)
e o o
m
ct S S
e
iv Y Y
n
it D D
t
y a a
D t t
at e e
a : :