Personal Information
Address
Educational Information
School Name & Address

If you haven't applied to Tougaloo and sent your transcripts and test scores, please email copies to tougalooNSD@gmail.com.

Intended Discipline to Major in College
1)
2)
Intended College to Attend
1)
2)
Please provide the names and email addresses of two referees

Reference Letters: Please arrange to email two letters of recommendation (Email: tougalooNSD@gmail.com)
Summer Science & Engineering Program Referral Form

Medical Information
Parent/Guardian Information
Signatures
(Please type your name for Signature.) I authorize the verification of the information provided on this form.
(for minors)
In addition to submitting the application below, you must also submit your Transcript; your ACT/SAT; an Essay narrating your interest, strength, weakness, and career goals (Maximum 400 words); and two letters of recommendation. These documents must be e-mailed to tougalooNSD@gmail.com in order to complete your application. For questions, please contact: Dr. M. Watkins 601-977-7794.
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