College Connect Locations
Summer Application
SUNO Campus: Miguel Devezin Bashful
Bashful Administration Bldg., Rm 210
Phone: 504-286-5007
Fax: 504-286-5213
Email: [email protected]
SUBR Campus: Carey Williams
Stewart Hall, Rm 107
Phone: 225-771-5630
Fax: 225-771-4954
Email: [email protected]
Academic Year 2015-2016
Office of Student Financial Aid & Scholarships
L.C. Barnes Administration Bldg., Room A-43
3050 Martin Luther King, Jr. Drive
Shreveport, La 71107
Phone: (318) 670-9221 • Fax: (318) 670-6313 • Email: [email protected]
Please complete entire form and return to the Office of Student Financial Aid. Processing cannot continue without this form.
DEMOGRAPHIC INFORMATION
9000
Name: _______________________________________________________________ Banner ID#: ___________________________________________
Permanent Address: ____________________________________________________________________________________________________________
Number & Street
Birth Date: ____________________________________________________
City
State
Zip
Phone: ________________________________________________
What semesters did you attend Southern University at Shreveport? (Check all that apply)
Fall 2015
Spring 2016
Please keep in mind that you are may not be eligible to receive financial aid for the Summer if:
1.
2.
3.
4.
5.
If you have already received the maximum Pell Grant allowed for the 2015-2016 academic year.
If you have not met Satisfactory Academic Progress (SAP) in accordance with the SAP Policy.
If you are classified as being in a “Special Program” and/or “Summer Only Student” according to your Admission file.
If you have not been admitted as a certificate or degree-seeking student.
If you are enrolling less than ½ time (3credit hrs.)
Will you receive a Fee Exemption, Tuition Waiver, and/or a Scholarship during the Summer I or Summer II 2016 term? If yes,
please specify ______________________________________________________________________________________
How many credit hours will you be enrolled in for the Summer I term ______ Summer II _______?
(Full-time = 6hrs or more, ¾ time = 4-5hrs, and ½ time = 3 hrs.)
Have you attended any institutions other than SUSLA (including colleges, universities, trade schools, etc.) from August 2015 to
present (i.e., Fall 2015 and/or Spring 2016)? Have all final official transcripts must be submitted and evaluated by the SUSLA Office
of Admissions? No Yes
If yes, list the institution(s):
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Session (I, II, or III)
Subject/ Course#
Course Title
Time/Day
Credit
Instructor
Hours
A Financial Aid Advisor will review your eligibility and award you accordingly. If you are eligible for Financial Aid, you may review your award online
at www.susla.edu via your Banner Web for Students account.
CERTIFICATION
I certify that the information on this form is true and complete and that I (1) have read and understand all the information contained in this form including the information about Satisfactory
Academic Progress; (2) do not owe money on a federal grant or have made arrangements to repay it; (3) am not in default on a federal student loan or have made satisfactory arrangements to
repay it; (4) will not receive any type of aid including Federal Pell Grant and Federal Direct Loans from more than one school for the same period of enrollment; and (5) will use federal student
financial aid only to pay for expenses related to attending Southern University at Shreveport.
________________________________________________________________
Student’s Signature
_________________________________________________
Date
________________________________________________________________
Financial Aid Advisor’s Signature
_________________________________________________
Date
Southern University at Shreveport does not discriminate on the basis of race, color, national origin, gender, age or disability. Title IX Coordinator: Ms. Tilisha T.
Bryant, Administration Building, Room A-43, (318) 670-9210. Section 504 Coordinator: Ms. Jerushka Ellis, Fine Arts Building, Room C04 D, (318) 670-9473.
Revised 03/2016