Mount Vernon Nazarene University - Special Award/Scholarship Announcement Request Form

Questions

Call:	(740) 397-9000, ext. 4341
E-mail:	jscott2@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:

Collegiate Degree And Accomplishments
Major/concentration* Second major (optional) Classification* Campus attended*

Accomplishment Information

Date of accomplishment* (mm/dd/yy): / /

Be specific and include as many details as possible, such as who the award is from or sponsored by, criteria for receiving the award, affiliation with any professional organization, etc.

Example: Smith received the Outstanding Chemistry Major Award, given by MVNU's School of Natural and Social Sciences and supported by the DOW Chemical Fund. Recipients must display excellence in the classroom and potential for adding to the chemistry profession.

Accomplishment information, include all if there are multiple (be as specific as possible: see example):*

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 Jeffrey Scott in the Communications Office.