LSU Independent and Distance Learning
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Accounting Credit Certificate Program
Application Form for Admission

* Required information

Personal Information

*First Name:
*Last Name:
Middle Initial:
*Address:
Address2:
*City:
*State:
*Zip Code:
*E-Mail:
*Daytime Phone:

Educational Background and Academic Credits

*1. Bachelorís degree confirmation
I earned a bachelorís degree (B.A. or B.S.) from the accredited institution named below:
University:
State:
Year:
*2. Intermediate Accounting Certification I certify that I have earned six semester hours of credit (or the equivalent) in Intermediate Accounting.
University:
Dept & Course number(s):
Year(s):
*3. Transfer Credits
I do not wish to transfer any previously earned credits from an accredited college or university.

I wish to transfer one course equivalent to a required certificate course from an accredited college or university (credit must be shown on a supporting official transcript ). List the relevant course below:
Dept & Course number:
Course Title:
Year:
Credit hours:
Grade:
This course is equivalent
to LSU course:
An official transcript showing the bachelorís degree, and credit for 6 semester hours of Intermediate Accounting, and any course to be considered for transfer, must be sent directly to LSU Independent and Distance Learning, 1225 Pleasant Hall, Accounting Certificate Program, Baton Rouge, LA 70803. Faxed or photocopied transcripts are not acceptable.

*4. Recent Independent and Distance Learning courses
List relevant courses you have successfully completed through LSU Independent and Distance Learning and the year each course was completed. Credit must have been earned within two years of application to the certificate program (no transcript is necessary for credits earned through LSU Independent Study courses).
I have not completed relevant courses through LSU Independent and Distance Learning in the past two years.

Please apply the following courses completed through LSU Independent and Distance Learning in the past two years toward the Accounting Certificate:
Dept & Course Nr Course Title Year Grade

* By checking this box, I confirm that all of the information above is correct and complete to the best of my knowledge.

Payment Information

Application Fee: A $50 nonrefundable application fee
must accompany this application.
Card Type:
*Cardholder`s Name:
*Card Number:
*Expiration Date: mm yyyy






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