Mount Vernon Nazarene University - Dean's List Announcement Request Form

Deadline to submit form is July 1, 2009, for spring 2009 semester announcement.

Questions

Call:	(740) 397-9000, ext. 4341
E-mail:	ccrouch@mvnu.edu

* Required

Student Information

Student full name* (as you'd like it printed)
Gender*
E-mail*
Primary phone*
Address*
City*
State*
Zip*
Student ID
Please send a copy of the release for records.
By Mail By Email

Parent Information

If parents are married, please put both names in one field. If parents are divorced or separated, use both fields. If you only want one parent to receive information, use one field.

Parent name(s)
Parent address
City
State
Zip
Primary phone
E-mail
Please send a copy of the release for records.

Parent name(s)
Parent address
City
State
Zip
Primary phone
E-mail
Please send a copy of the release for records.

Spouse Information

Spouse name:
Is this person a current MVNU student?	Yes No
Is your spouse an MVNU graduate?	Yes No
If so, year:

Newspaper Information

Name of newspaper you wish release to be sent to*
Address*
City*
State*
Primary phone*
News desk e-mail address*

Education Information

High School

Name of high school graduated from:*
City*	State*	Year*

College

Name of any previous college(s) attended:
Degree(s) earned:
City	State	Year

Name of any previous college(s) attended:
Degree(s) earned:
City	State	Year

AGS Information (AGS students only)
Current employer and position: Degree program: Campus attended:

Collegiate Degree And Accomplishments
Major/concentration* Second major (optional) Classification* Number of semesters on Dean's List, including this one:* (please refer to your letter from the Academic Affairs Office) GPA for Dean's List semester:* (please refer to your letter from the Academic Affairs Office) Any additional info you want to add:

Special Instructions
If you have one additional newspaper you would like your release sent to, please provide complete contact information for the paper here. Other special instructions will be followed if possible. Comments or special instructions regarding this release:

After verifying that all above information is correct, please click the SUBMIT button below to process your release.

If you are experiencing problems with the form or have any questions about your press release, contact Carrie Crouch in the Communications Office.