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Publicity Form

This publicity form provides the office of university communications with information to complete a news release on your activity, which will be sent to your hometown newspaper. Completing this form indicates your permission to release the information contained in this form. If you do not want a news release sent, please do not fill out the form.

Instructions: Complete each field, and enter information as you wish it to appear in your local newspaper. Please follow the examples provided when inputting your information.

Personal Information

Name: (e.g. John R. Smith, Alice Jones)

Major:

Enter degree option or emphasis if applicable:

If graduate student, specify degree and program:

Marital Status:

Single
Married

If married, please list spouse's name.

Gender:

Male
Female

Year in School:

If other, please specify.

Hometown:: St. Louis, Columbia

State:

High School Attended:: Central High School

Year Graduated:: 1999

Skip the next three fields if you have no previous degrees

Previous Degree:: Associate of Arts

College Attended:: Ozarks Technical Community College

Year Graduated:: 2001

Parent/Guardian Information

List parents' names, hometown as you wish them to appear:: John and Joan Smith, St. Louis, MO

Indicate relationship if not parent.

Hometown Newspaper Information

Name of Newspaper:: Joplin Globe, Springfield News-Leader

City of Newspaper:: Springfield, Jefferson City

State of newspaper:

County of Newspaper (if located in Missouri):

Event Information

Name of Event, Award or Recognition:: Alpha Kappa Psi Achievement Scholarship

Date of Event, Award or Recognition:: June 10, 2002

Department or Organization Sponsoring Event:: College of Business Administration

Activity Information

Missouri State group memberships:

List Up to Four Honors, Awards or Leadership Positions:

1.: President, Student Activities Council

2.: Dean's List

3.: Freshman Academic Scholarship recipient

4.: Secretary, Gamma Sigma Sigma Sorority