Name: Male Female Born: Month: Day: Year:
United States Citizen or National Lawful Permanent Resident Social Security Number:
Term first enrolled or planning to enroll in Loyola: Fall Spring Summer 20 I plan to major in:
Permanent Address: Number and Street: City: State: Zip: Home Phone: ( ) -
Cell Phone: ( ) - E-mail address:
If you are a transfer student, please list college(s) attended beginning with the most recent, the number of hours completed, and your GPA, and then proceed to Section C. If you need more room for section B, you may make an attachment.
Dates are Month/Year-Month/Year. Dates: College: City: State: Dates: College: City: State: Hours completed: Cumulative grade point average after the Fall 2009 semester:
High school students: List high schools attended beginning with the most recent.
Dates are Month/Year-Month/Year. Dates: High School: City: State: Dates: High School: City: State: ACT composite: and/or SAT Verbal: Math: Cumulative grade point average after the Fall 2009 semester: High School Principal: High School Counselor:
See next page for additional directions.
Signature: Date:
Type and attach a personal statement of approximately 250 words (one double-spaced page) to support your application. You may discuss such topics as your reasons for choosing your field of study, how you plan to use your education after graduation, leadership and service activities in which you have engaged, and/or how you have overcome hardships to pursue your goals.
Students not yet admitted to Loyola, must also submit all admission materials by February 1, 2010.
Please make a copy of your completed application for your records.
Scholarship recipients will be notified prior to April 1, 2010.
Loyola University Chicago is an equal opportunity educator and employer and admits students without regard to their race, color, sex or national or ethnic origin. Qualified persons are not subject to discrimination on the basis of handicap.
