<p> Kentucky State University LOUIS STOKES ALLIANCE FOR MINORITY PARTICIPATION 2011 Summer Bridge Program for Rising Juniors & Seniors APPLICATION FORM</p><p>Name:______e-mail:______</p><p>Mailing Address:______</p><p>City:______State:______Zip Code______</p><p>Parent/Guardian:______</p><p>Telephone: (Home):______(Cell):______</p><p>Current Grade:______Grade Point Average:______ACT: Com.______Math______</p><p>Current School:______School Attending in Fall 2011:______</p><p>Awards/Achievements: ______</p><p>College/Career Plans: (200-250 words. Type in the space below or attach a separate page):______</p><p>Please enclose (or e-mail) two letters of recommendation and a copy of current transcript. Accepted applicants must participate in all LSAMP activities during the program. (June 12th to July 1st, 2011) Electronic application accepted. Applicants will be notified via e-mail only. Application deadline: April 15, 2011. Mail Application to: Criteria for Application: Dr. Kazi Javed 1) Rising HS Juniors or Seniors Kentucky State University 2) Overall high school GPA of 2.8 or better 400 East-Main St. 3) ACT score of 20 or better Frankfort, KY 40601 4) Completed application, transcripts, (502)597-6722 two recommendation letters, one picture. [email protected] </p>