Geology Intensive Orientation for Students 2011 Student Application
Applicants must complete all fields in the “GIOS Course” Secion. Those requesting on-campus housing in a 2-person dormitory room must complete the “Housing” Section. When you are accepted you will be notified by email to your PAWS email address and the applicable charges will be posted to your PAWS account. The e-mail will also provide instructions for how to pay these charges using your PAWS account. You must pay the applicable charges through your PAWS account within two weeks of the email notifaction in order to reserve a space. Enrollment is limited, and all spaces assigned are on a first come/first serve basis. Refunds cannot be given after July 11, 2011.
First Name:
____________________________________
Last Name:
____________________________________
PAWS E-mail Address:
____________________________________
Secondary E-mail Address:
____________________________________
Home Address:
____________________________________
City:
____________________________________
State:
____________________________________
Zip Code:
____________________________________
Phone:
____________________________________
Date of Birth:
____________________________________
LSU ID #:
____________________________________
High School:
____________________________________
City, State:
____________________________________
1st Generation College Student:
Yes
No
Do you wish for program housing:
Yes
No
Roommate Preference (optional):
____________________________________
Department of Geology & Geophysics E-235 Howe-Russell-Kniffen• Baton Rouge, LA 70803 Phone: 225-578-3353 • Fax: 225-578-2302 GIOS@lsu.edu • www.geol.lsu.edu