Lesbian, Bisexual, Gay, Transgender Resource Center

Michigan State University

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302 Student Services Building
Michigan State University
East Lansing MI 48824
Phone: (517) 353-9520
Fax: (517) 432-1495
Email: lbgtrc @ msu.edu

Monday-Friday 8:00 am - 5:00 pm
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LBGT Events Calendar

MSU LBGT Scholarships Application Form for 2009

Please print a copy of this form for yourself before you submit the form. There is no way to save this form and return to continue working with it at a later date, but you may paste text into this form from a file. When you submit the form, the contents are emailed to the secretary in the LBGT Resource Center, who will email you an acknowledgement.

Legal name:

Preferred name (if different):

PID (if MSU student):

Email address:

Phone number(s):

Home mailing address:

Campus mailing address (if known):

Reference 1 (optional):

Reference 2 (optional):

I wish to be considered for these scholarships:
Pride Students of Color Pougnet/Green

I have submitted my essay separately: yes no

I heard about these opportunities through:
admissions process web search someone told me
other:

By submitting your application you are giving us permission to access your MSU academic records or admissions information.

Remember to mail or email (MS Word or PDF) your essay separately! Your application is not complete until we receive your essay.

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