Hometown News Bureau Release

Faculty, staff and students are asked to let us know about their accomplishments (awards, honors, etc.) so we can inform the media, including their local newspapers.

Name Name * First Middle Last
Email *
Phone Phone * - ### - ### ####
Local Address Local Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Recognition / Award Received *
Major / Department *
Date Received Date Received * / MM / DD YYYY
Details of Recognition / Award *
Year in School or Campus Position *
Name of High School
City / Town of High School
Year Graduated from High School
Student Home Town

You will be listed as being from here in the release.
Important

We will send a release to the hometown newspaper of your family and/or spouse or partner as you indicate below.
Parent / Guardian / Family Newspaper
Parent / Guardian / Family Newspaper Name
Parent / Guardian / Family Newspaper Address Parent / Guardian / Family Newspaper Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Parent / Guardian / Family Name(s)
Parent / Guardian / Family Address Parent / Guardian / Family Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Spouse / Partner Newspaper
Spouse / Partner Newspaper Name
Spouse / Partner Newspaper Address Spouse / Partner Newspaper Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Spouse / Partner's Name Spouse / Partner's Name First Last
Children's Name(s)
Your Signature

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.

Hometown News Bureau Release

Hometown News Bureau Release

Important

Parent / Guardian / Family Newspaper

Spouse / Partner Newspaper