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Alumni Achievement Form
Information that you provide us on this form will help us in our effort to announce alumni accomplishments.This information will appear in the "Class Notes" section of the ISU Magazine and may possibly be used as a feature story for other internal and external publications. All submissions are subject to verification before release. All fields in red are required.
Today's date:


Contact Information
Name:
(someone very knowledgeable about the award/honor)
Phone:
Fax:
Email:
URL:


Tell us about this interesting Alum!
First Name:
Last
Name:
Maiden
Name:
Job Title:
Business
Name:

Business:
Address:
Phone:
Email:
Fax:

Home:
Address:
Phone:
Email:
Year graduated from ISU:


Other Degrees:
Degree:     Year:
Institution:   

Degree:     Year:
Institution:   

Degree:      Year:
Institution:   
 
Hometown:
Home State:


      If other than Indiana
Home
Country:


About the award
Name of award/appointment/achievement:

Date and occasion of presentation:
(i.e. July 9, 2000; annual American Psychological Association conference)

Place of presentation:
(i.e. RCA Dome, Indianapolis)


person(s) received this award/honor out of people nominated.

Describe in 250 words or less the criteria or significance of the award/honor and a brief description of the awarding organization.

Please provide a name and phone number of someone affiliated with this honor/activity who we can contact for quotes.
Name:
Phone:
Email:

This information is routinely forwarded to the editor of the ISU Magazine for inclusion in the Class Notes section. If you would like the release to be sent to other publications or media outlets, please provide the following information: 
Name of publication:

Mailing
Address:
City:
State:
Zip code:
Country:

(If other than US)
Fax #:
Name of publication:

Mailing
Address:
City:
State:
Zip code:
Country:

(If other than US)
Fax #:

Please take a moment to review your entry before submitting it to our office.  Thank you for taking the time to tell us your news, and congratulations on your achievement.


Updated August 05, 2003
Copyright © 2002 Office of Public Affairs