# Louisiana Smart Start Scholarship Application

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4 Student Name Student The above named student is applying for the Louisiana Smart Start Scholarship. One of the requirements to complete this application is to have this form completed by their Guidance Counselor and an official and most recent transcript of grades and a high school profile mailed or ed to the address listed below. Failure to provide the transcript will disqualify the student from the scholarship program. Please complete this form and return it with the requested documents to the or address below by January 17, GUIDANCE COUNSELOR CONTACT INFORMATION (Required for all applicants) Title First Name Last Name Address Phone Number High School Name ACADEMIC INFORMATION-HIGH SCHOOL (Required for all applicants) Is this student a senior in high school? (Circle One) YES The GPA is (circle one): weighted / un-weighted ACT Composite SAT-Critical Reading SAT-Math SAT-Written NO Number of semesters the student has completed: GPA on a 4.0 scale * Class Rank Class Size My School does not rank students * Converting the GPA is a simple process. Start by finding out the GPA Scale. Then divide the GPA by that number and multiply the result by four (4). The standardized GPA should be rounded to two (2) decimal points. If the last digit in the GPA is 1 through 4, round down (i.e becomes 3.53). If the last digit in the GPA is 5 through 9, round up (i.e becomes 3.54). For example: If the GPA is 5.3 on a scale of 6.0, the process is: If the GPA is 79 on a scale of 100, the process is: Divide the GPA (5.3) by the GPA scale (6.0): = Divide the GPA (79) by the GPA scale (100): = 0.79 Now take this result (0.8833) and multiply by 4:.8833 X 4 = Now take this result (0.79) and multiply by 4:.79 X 4 = 3.16 The standardized GPA you should enter on the application is The standardized GPA you should enter on the application is 3.16.

7 APPLICATION CHECKLIST- You may use the following checklist to ensure the application process is complete. All documents must arrive in the same package for the submission to be considered complete. Incomplete applications will not be considered. I have included my complete, signed application. I have included a copy of my Student Aid Report. I have included my essays. I have requested my professional and personal recommendations from either a teacher or an employer. I have requested my academic verification from my high school Guidance Counselor. I understand these documents may be scanned and I have not stapled or clipped pages together. I have kept a copy of my entire submission for my records. I am submitting my application prior to the deadline of January 17, TERMS and CONDITIONS I understand it is my responsibility to make sure the application process is complete by the required deadline. If not, the application may be disqualified from the awards competition and may not be considered for an award. This application, upon receipt, becomes the property of the program sponsor, and of International Scholarship and Tuition Services, Inc. I agree that, if selected as an award winner for the Louisiana Smart Start Scholarship, the program sponsor or its agents may use my name and likeness and any other information or materials provided in connection with this program for purposes of news, publicity and advertising in all media, including but not limited to print and electronic media, press releases, internet websites, and video media. To comply with the provisions of the Family Educational Rights and Privacy Act of 1974, I hereby grant permission for school officials to release secondary school records and other requested information, if necessary. If you are under 18, your parent or guardian must also agree to these Terms and Conditions. Student Signature Date Parent/Guardian Signature (if student is under 18 years old) Date

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