Individual Applying:
Chapter Affiliation:
Phone Number:
Email:
Local Address:
Cumulative Grade Point Average:
Expected Date of Graduation:
Major:
Minor:
Class Standing: Freshman Sophomore Junior Senior
Year you were initiated to your fraternity/sorority:
Please use the space below to answer the following questions. Please limit responses to 250 words per question. In addition it is your responsibility to make sure 2 references submit the reverence form by the due date.
If you have any supporting documents, please send them as a PDF to campusawards@uww.edu. Please include the award and your name in the subject line.
Please have 2 references fill out and submit the reference form.
Name:
Address:
Please submit and return all award materials no later than 4:00 pm on Friday, April 1, 2011.