Last name
First name
Street Address
City
State and ZIP
Permanent Street Address (if different)
Permanent City (if different)
Permanent State and ZIP (if different)
E-mail address
Student ID Number
Choose appropriate concentration
Communication Studies
Media Studies
Corporate and Organizational Communication
Minor? (indicate which)
Other major(s)? (indicate
which)
Are you an Honors Student?
Yes
No
Expected date of graduation
Please list and describe any internships you have
completed to date. Be sure to include any accomplishments and/or
special recognitions.
Company
Position Title
Did you receive academic credit for your internship?
Yes
No
Duties and Accomplishments
Please describe any research projects you have completed
(e.g. Bachelor's Essay, Independent Study, PR Campaigns, etc.).
If any are "near completion" or "in progress," include those also.
Title
Faculty Advisor
Description:
Please list any relevant presentations or
publications of this work:
Please identify any outside experience relating
to your major and/or field of study (e.g. work, community service,
volunteering, PRSSA, COMM Club, Lambda Pi Eta). Be sure to include
the name of the organization, your title or position (if any), and
how you feel it relates to your major/field of study.
Please list and describe your participation in
other extracurricular/academic activities. Be sure to include awards,
officer positions, or significant accomplishments.
Please list any academic honors you have received.
Please include anything else you think we should
know as we consider you for this/these award(s).
Of all the things you have included in this application,
please identify the three you are most proud of and tell us why.
Deadline for sending this form is April 11.