Appeal for Admission

Contact Information

Last Name *

First Name *

MI *

ULM Campus-Wide ID (if former ULM Student)

Date of Birth (mm/dd/yyyy) *

Month

Day

Year

Phone (XXX)XXX-XXX *

(

Phone (XXX)XXX-XXX, part 1

)

Phone (XXX)XXX-XXX, part 2

Phone (XXX)XXX-XXX, part 3

Email Address *

Domestic/International Student *

Domestic

International

Street Address *

City *

State *

Zip Code *

Zip Code, part 1

Semester/Year Applying for (i.e., Fall 2020) *

Part I

Please provide a brief statement indicating your reason(s) for this appeal and why you believe you will be a successful student at ULM, if given this opportunity. *

Email a separate sheet if necessary, to admissions@ulm.edu

Is either parent a ULM graduate? *

Yes

If "YES", Please provide the following information:

Father's full name while in attendance at ULM

Mother's full name (include maiden name) while in attendance at ULM

Father's Campus-Wide ID (CWID) Number

Mother's Campus-Wide ID (CWID) Numner

Transfer students with less than 18 credit hours must submit official copies of their high school transcript and official ACT/SAT scores (sent directly to ULM from ACT/SAT)

You may submit supporting documents and/or recommendation letters for this appeal to admissions@ulm.edu

Part II

Grid *

	YES	NO
Have you been offered or awarded a ULM Athletic Scholarship? *	Have you been offered or awarded a ULM Athletic Scholarship? - YES	Have you been offered or awarded a ULM Athletic Scholarship? - NO
Have you signed a National Letter of Intent for ULM? *	Have you signed a National Letter of Intent for ULM? - YES	Have you signed a National Letter of Intent for ULM? - NO
Have you been offered or awarded a ULM Talent Grant (band, art, etc.?) *	Have you been offered or awarded a ULM Talent Grant (band, art, etc.?) - YES	Have you been offered or awarded a ULM Talent Grant (band, art, etc.?) - NO
Have you previously attended ULM? If so, list semester(s)/year(s) *	Have you previously attended ULM? If so, list semester(s)/year(s) - YES	Have you previously attended ULM? If so, list semester(s)/year(s) - NO

If you have previously attended ULM, list semester(s)/year(s) : *

Terms of Acceptance and Signature

I, the applicant for this Appeal of Admissions Decision Form, warrant the truthfulness of the information provided.

Terms Acceptance *

I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance. By providing my full name as an electronic signature and providing a date, I agree that my electronic signature is the legally binding equivalent to my handwritten signature. My electronic signature has the same validity and meaning as my handwritten signature. I will not, at any time, repudiate the meaning of my electronic signature or claim that my electronic signature is not legally binding.

Print Full Name *

Date *

Month

Day

Year

You will be informed of a decision within ten (10) business days. For information regarding your appeal or its status, please contact the ULM Office of Admissions at admissions@ulm.edu or 318-342-5430.

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