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Lifestyle & Personal Information

Steeple's Glen At Louisiana Tech

Mr. Ms.     Age 

Permanent Street Address

City      State        Zip    

Home Phone

Email Address

Class Level:

Roommate Name Preference

Do you smoke?     No   Yes 

Do you consider yourself to be a   studier?

Do you plan to study in your room? Yes   No

Do you keep your belongings

Are you an early riser?   Late riser?   

What is your major field of study?

Which school will you be attending?
Please list all of your high school or college extra-curricular activities and/or honors below (e.g. fraternity, sorority, academic association(s), varsity sports, student government, intramural).
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