LEADERSHIP SCHOLAR PROGRAM (LSP) Application

Please fill in the following information as thoroughly as possible.

PRIVACY ACT STATEMENT

AUTHORITY: 5 U.S.C. 301, Departmental Regulations; 10 U.S.C. 5031, Secretary of the Navy; 10 U.S.C. 5041, Headquarters, Marine Corps; and E.O. 9397 (SSN). PRINCIPAL PURPOSE(S): To facilitate an individual's request for participation in the Leadership Scholar Program. ROUTINE USE(S): None. DISCLOSURE: Voluntary; however, you will not be evaluated for participation in the Leadership Scholar Program if you fail to provide requested information.

Today's Date:
First Name: Last Name:
Middle Initial: Suffix:
Rank: MOS:
State Residency: Email Address:
Home Phone: Cell Phone:
Mailing Address:
Unit:
Installation:
EAS Date:

1st School Choice
2nd School Choice
3rd School Choice

Intended Semester:
Intended Major:
High School Attended:
High School GPA:
Colleges Attended:
Date SAT/ACT Taken: (MM/DD/YYYY)
SAT/ACT Score: SAT/ACT Math Score:
AFQT Score: GT Score:
Does the LSP have your permission to share your academic records/background with your intended school?

Yes

How did you hear about the LSP:

High School Transcripts: One unofficial transcripts from your high school. These are available from your high school registrar office.
College Transcripts: One unofficial transcript from each school attended. College transcripts are available from the college registrar office, and they can often be requested / obtained online.
You may request a JST transcript from the following website https://jst.doded.mil/smart/signin.doJoint Services Transcript
Certified copies of NAVMC 118 (Service Record Book, pages (3), (11), and (12)).
Certified copies of ROS, BIR, BTR, Awards Page, and Education Record (TEDU): All of this information is in MCTFS (3270) at your administrative office.
Letter of recommendation: Please provide us with a letter of recommendation from your commanding offier or any officer for whom you have served. You may submit this application online and you will receive an email letting you know where to send the required documentation. You may also print and submit this application with all of the required documentation to the following address: By mail: Leadership Scholar Program, Marine and Family Programs Division (MFR), 3820 Russell Road, Quantico, Virginia 22134, ATTN: Rhonda Normandin

Leadership Scholar Program

Student Application

LEADERSHIP SCHOLAR PROGRAM (LSP) Application

PRIVACY ACT STATEMENT

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