Undergraduate LSAMP Forms


Some forms are PDF format. In order to open and edit these documents, you must have Adobe Reader installed on your computer. 

The following are common forms used by the LSAMP program:

New LSAMP Application Form

Initiated in 1993-1994, CSU-LSAMP is an alliance of the 23 campuses of the California State University (CSU) system which supports a coordinated and comprehensive system-wide approach to broadening participation in science, technology, engineering and mathematics (STEM) disciplines.

Each of the CSU campuses has a CSU-LSAMP program that offers an array of activities and services designed to improve retention and graduation of undergraduate students in STEM. In addition, CSU-LSAMP seeks to increase the number of CSU-LSAMP students who enter STEM graduate programs or the STEM workforce.

 To be eligible to participate in CSU-LSAMP, students must:

·       Be a U.S. Citizen or Permanent Resident.

·       Be enrolled at a participating campus in an undergraduate major in a STEM discipline or have expressed an interest in pursuing a STEM baccalaureate degree.

·       Be an individual who has faced or faces social, educational, or economic barriers to careers in STEM.  

·       Each CSU-LSAMP campus program may have additional eligibility requirements.  Please see the Campus Coordinator.

Please follow the instructions accompanying the New LSAMP Application Form exactly. Submit all required application components to the LSAMP office (ASCB 360) during the posted office hours. Please click the appropriate links below to obtain the instructions and application form. Application materials for NEW LSAMP students become available around September 1st of each year.

LSAMP Program @ Cal State LA Information

New LSAMP Student Application Form for AY 2020-2021

Continuing LSAMP Application Form

Applications are accepted year round, but to be eligible for any LSAMP components including Early Registration, a valid NEW or CONTINUING STUDENT application must be on file and approved for the year in question. Each year runs September 1 through August 31 (e.g., current year is September 1, 2020 through August 31, 2021.) 

Since you already completed the new student LSAMP application form (in fall 2013 or later), you no longer need to fill one out again. Instead, just take the time to update information and update your “MY PLANNER,” available in GET. Each year you remain an undergraduate student enrolled in a STEM (Science, Technology, Engineering, or Mathematics) major and continue to work on your first bachelor’s degree, we will request that you complete updated information if you wish to continue as an ACTIVE LSAMP participant. You may bring the completed "My Planner" to the LSAMP office (ASC Rosser – Room 360) or you may email all required documents to [email protected]

Continuing LSAMP Student Application Form for AY 2020-2021

Early Registration Form

The Early Registration Request deadline for each fall and spring term is provided on the main homepage.

Beginning Spring Semester, 2017 and all later terms, for early registration requests, students must have completed 3 seminar evaluations before the Request deadline (or a total of 6 seminar evaluations per program year, September 1 through August 31, to be eligible for both FALL and SPRING early registration. Make sure that you have submitted the -seminar evaluations to the LSAMP office (ASC-Rosser 360) within an hour after each seminar has ended. Also you need to provide a copy of your grades for the last term completed and what courses you plan to register in for the specific term you are requesting Early Registration. These items should be submitted or emailed ([email protected]) to the LSAMP Office in addition to providing documentation of participation in at least one LSAMP activity during the prior academic term with the early registration form located below before the deadline.

Summary of Everything you must submit for Early Registration Requests before Term Deadline:

  1. The Completed Early Registration Form located below.
  2. The 3 seminar evaluations per term or 6 total for each LSAMP funded year = September 1 through August 31 (which are due in the LSAMP Office – ASC - Rosser 360 within 2 hours after the seminar ends).
  3. Documentation that you participated in one of the LSAMP-sponsored activities prior to the Early Registration Request Deadline for each term.
  4. A print out of your previous semester grades
  5. A list of courses that you plan to register for on the Early Registration date.

 Early Registration Form

Seminar Evaluation Form

This form should be completed for each speaker and submitted to the LSAMP Office within 2 hours after the seminar – only handwritten copies will be accepted. Therefore, you may either print out a few copies of this form to be handwritten legibly during the seminar or pick up some forms from the LSAMP Office. Please click the link below to access the Seminar Evaluation Form.

Seminar Evaluation Form

LSAMP Student Travel Request Form

A detailed set of instructions and travel request procedures was distributed to all LSAMP students at the start of Fall Semester, 2017. This information is also attached here in the link labelled “Travel Request Procedures,” which contains and describes the steps to request travel funds to professional conferences. If you have plans to make such requests, please read this document carefully BEFORE completing any forms.

LSAMP Student Travel Request Form

LSAMP Student Airfare Pre-Pay Form

Responsible Conduct Research Training

All LSAMP students engaged in research and receiving a stipend for research activities through NSF funding must complete this training activity required by NSF before any stipend check can be released to you.  You must submit to Dr. Jefferson and Dr, Yamazaki a copy of the Main Page (which will have your name printed on the upper right corner) that shows you have passed and completed the training on Responsible Conduct of Research. More instructions on what and when to print out this document appear in the link below. The training occurs through a web link to a site at Sacramento State. Please click the link below to access the Responsible Conduct Research Training Instructions.

Responsible Conduct Research Training Instructions

LSAMP Undergraduate Acknowledgement Statement

Whenever CSU-LSAMP @ Cal State LA program provides travel support, stipend support, or research supply support for work that you submit for presentation at conferences or publications in journals, etc. you need to properly acknowledge such support when submitting abstracts, publications, and poster or oral presentations. The link below states the wording that should be used in such acknowledgements. Also be certain to submit an electronic copy of abstracts and/or publications to [email protected]

LSAMP Undergraduate Acknowledgement Statement

CSU-LSAMP is supported by the National Science Foundation under Grant # HRD-1302873 and the CSU Office of the Chancellor.