Student Information

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Student Email Address

Student First Name

Student Middle Name

Student Last Name

Student Goes By:

Are you a former Summer Honors student?

YesNo

What is your gender?

MaleFemale

What will be/is your classification in high school during the Spring of 2020?

JuniorSenior

Have you applied to Lee University?

YesNo

What is your T-shirt size?

Student Social Security Number

Not required

Student Date of Birth

Student Street Address

Student City

Student State

Student Zip Code

Student Mobile Phone

Student Home Phone

Parent Guardian Information

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Mobile Phone

Parent/Guardian Home Phone

Parent/Guardian Email

Emergency Contact (if different from Parent/Guardian)

Emergency Contact Name

Emergency Contact Cell Phone

Emergency Contact Home Phone

Emergency Contact Work Phone

General Information

Please indicate any preexisting medical conditions and/or medications of which we should be aware

If you have any dietary restrictions or preferences, what are they?

If you have a roommate preference, what is his/her name?

How did you hear about Summer Honors?

What is your best guess as to your college major?

Please send the following materials to:

Dr. Mike Hayes, Summer Honors, Lee University
P.O. Box 3450
Cleveland, TN 37320

Confirmation of your score of at least a 24 on the ACT or at least an 1120 on the SAT OR a letter or recommendation from your high school principal or counselor that verifies that you have maintained a 3.2 GPA on a 4-point scale during high school.

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Application for Summer Honors