Academic Renewal Application

First Name

Middle Name

Last Name

Email Address

Birthdate

Mobile Phone

May we text you at this number?

Yes

No

By checking this box, you are providing your express written consent that Louisiana Tech University may, directly or through third-parties acting on its behalf, send marketing information regarding Louisiana Tech University and your continuing education, including texts, emails, and phone calls that you provided above. Providing this consent is not required to obtain any good or service.

Address

Country

Street

City

Region

Postal Code

Quarter in which you are enrolling

Year

For your application to be considered:
1- You must have a completed admissions application on file including official transcripts.
2- You must answer all questions on this form.

My reason for applying for Academic Renewal is:

Please explain what circumstances have changed that would support your academic success in the future.

By signing this application, I hereby certify that I have read the Academic Renewal Policy in its entirety, and that I have answered all questions truthfully and to the best of my ability.

Click to Sign...