DEPARTMENT OF ENGLISH Name: Last First Initial 1 2 3 4 Print - latech 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your name in the designated fields: Last, First, and Initial. Ensure accuracy as this will be used for official records.
3. Fill in any variations of your name that may appear on official documents, followed by your Social Security Number and Campus-Wide ID if available.
4. Complete the Current Address section with your city, state, zip code, and country. Repeat this for your Permanent Address.
5. Input both current and permanent phone numbers along with your email address for communication purposes.
6. List the names of high schools or colleges you have attended in the provided spaces. Include up to four institutions.
7. Indicate your Degree Program at LA Tech and expected graduation date. Fill in the Dates Attended along with Diploma or Hours Earned information.
8. In the final section, provide any additional information that may support your application, using complete sentences to articulate memberships, awards, work experience, future goals, and interests.

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