(* Required)  
Who's Who in American Universities and Colleges
Nominee: *

Student ID #: *

Email: *

Local Address: *

City, State & Zip Code:

Campus/Cell #: *

Major: *

(Note: We are required to submit the above information to Who's Who headquarters in Tuscaloosa, AL. If your application is accepted, they will contact you about purchasing Who's Who merchandise, in addition to the certificate that you will receive at the Student Affairs Outstanding Student Awards Program. You are in no way obligated to do so.)
Please give a brief biographical sketch of all activities, honors or organizations/functions in which you have taken part: this should include community (home or campus) involvement, academic achievement, and involvement in student organizations. All applicants must have a 2.5 QPA and have at least 64 credits (junior) or more in class standing.
Hometown Newspaper:

During Freshman Year: *
During Sophomore Year: *
During Junior Year: *
During Senior Year:
During Graduate School:
Please list two references and their contact information in the space provided.


Deadline: This form must be submitted by Friday, March 9, 2012 at 4pm to Student Affairs, Alumni Hall 323 or adunham@mansfield.edu
Note: If you have already received a Who's Who Award, please do not resubmit.