First Name:  Last Name:

Department:

College:

Rank: Select One Professor Associate Professor Assistant Professor

Campus Mailing Address:

Phone: (225) 578   Fax: (225) 578

Email: @lsu.edu

Department or personal Web site:

Using key words and/or very brief phrases(no more than 15 words), describe the area(s) of research, scholorship, or creative activities in which a program participant would take part:

Title and full citation for a recent publication or equivalent scholarly product: