To participate in the Sophomore Summer Institute, you must have at least a 3.0 Grade Point Average and must have completed 45 credit hours by the time you submit your application.

First Name Middle Last Name

The Last four digits of your SSN:

Permanent Address
Perm City Perm State Select Outside US / Canada Alabama Alaska Alberta American Samoa Arizona Arkansas Armed Forces Americas Armed Forces Europe Armed Forces Pacific British Columbia California Colorado Connecticut Delaware District Of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northern Mariana Is Northwest Territories Nova Scotia Ohio Oklahoma Ontario Oregon Palau Pennsylvania Prince Edward Island Province du Quebec Puerto Rico Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Yukon Territory Perm Zip
Perm Telephone ( ) - Cell Phone ( ) -

Present Address (if different from permanent)
Present City Present State Outside US / Canada Alabama Alaska Alberta American Samoa Arizona Arkansas Armed Forces Americas Armed Forces Europe Armed Forces Pacific British Columbia California Colorado Connecticut Delaware District Of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northern Mariana Is Northwest Territories Nova Scotia Ohio Oklahoma Ontario Oregon Palau Pennsylvania Prince Edward Island Province du Quebec Puerto Rico Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Yukon Territory Present Zip
Present Phone ( ) - Fax ( ) -

E-mail Address
IMPORTANT: Applications MUST CONTAIN A FUNCTIONING E-MAIL ADDRESS because final details may be communicated via e-mail. Please do NOT let your e-mail boxes fill up; if this happens, the e-mail will not be received and will be bounced back without delivery!

Date of Birth Month 01 02 03 04 05 06 07 08 09 10 11 12 Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 Place of Birth
Gender Select Female Male Are you a U.S. Citizen? Yes No   What is your state of residence?

Academic History
High School from which you graduated:
High School Name
High School City High School State High School Graduation Date

List in reverse chronological order (most recent first) all undergraduate colleges attended:
Institution (1) Major(s) GPA
Institution (1) Address/City Institution (1) State Outside US / Canada Alabama Alaska Alberta American Samoa Arizona Arkansas Armed Forces Americas Armed Forces Europe Armed Forces Pacific British Columbia California Colorado Connecticut Delaware District Of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northern Mariana Is Northwest Territories Nova Scotia Ohio Oklahoma Ontario Oregon Palau Pennsylvania Prince Edward Island Province du Quebec Puerto Rico Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Yukon Territory From/To

Institution (2) From/To Major(s)
Institution (2) Address/City/State

Institution (3) From/To Major(s)
Institution (3) Address/City/State

If you answer "Yes" to either of the next two questions, please attach a letter of explanation with your application.

1. Have you ever been suspended or required to withdraw from any college/university? Yes No

2. Have you ever been convicted of a criminal offense? Yes No

Eligibility Requirements
In order to participate in the CLEO College Scholars Sophomore Summer Institute Program, you must be either a minority, low-income or otherwise disadvantaged student.

Ethnicity: Select African African American West Indian/Caribbean Caucasian Asian, Pacific Islander Asian,Other American Indian/Alaskan Native Other Hispanic, Mexican Hispanic, Puerto Rican Hispanic, Other Other

Low-income, Economically, or Otherwise Disadvantaged
1. A student may be determined to be low-income only if he/she earned less than 150% of the HHS poverty guidelines AND his/her parents earned less than $40,000. An independent student may be determined to be economically disadvantaged if his/her income is less than 185% of the HHS poverty guidelines.

a. Are you low-income? Yes No
b. Are you economically disadvantaged? Yes No
If you answered "Yes" to questions "a" or "b" please submit a copy of your Student Aid Report.

2. An individual may be determined to be otherwise disadvantaged if he/she meets at least one of the following criteria (please check all that apply):

First generation college graduate
Participated in a TRIO program
Exhibits limited English proficiency
Resided in a public housing facility
Attended secondary school in a Title I School District
Disabled, as defined by the Americans with Disabilities Act

I understand that if I am selected I will be required to submit the appropriate documentation relevant to my eligibility to participate.

How did you find out about this CLEO program? CLEO Website Posted Flyer Mailing E-mailMessage Other Career Center Pre-Law Advisor
Identify Advisor and Institution

Have you participated in other CLEO Seminars? (check all that apply)
Road to Law School Sophomore Super Saturdays Juniors Jumpstart the LSAT CLEO Connection
Other

Extracurricular history

Scholarships, Awards, and Honors (add dates):

Community Service:

Post High School Employment and Professional Experience:

Extracurricular Activities:

COMMITMENT AGREEMENT
This program will extend through the academic year for continued enrichment with mandatory Saturday seminars.

I understand that by applying and being accepted to the program, I am making a year long commitment which begins with the four-week summer program, and requires my continuous attendance at a series of Saturday seminars over the course the 2010-2011 academic year.

Signature: