News Release Form

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Purpose of News Release *	Academic Awards Dean's List Theatre Performance Music Performance Art Show Scholarship/Fellowship (list name, type and amount) Other DO NOT SUBMIT INFORMATION FOR DEAN'S LIST OR GRADUATION -- THESE RELEASES ARE AUTOMATICALLY PROCESSED THROUGH INFORMATION RECEIVED FROM THE REGISTRAR'S OFFICE AND SENT TO HOMETOWN NEWSPAPERS.
Please describe *
Student Name *
	First and Last Name
E-mail Address *
Gender *	Female Male
Current Street Address *
City *
State *
Zip*
Current Phone Number:
Permanent Phone Number:
Contact Address and Phone Number After Commencement:

Parent 1 Full Name:	Please list parents' name how it should be written in the release. For example: John and Joan Doe of Anywhere, GA or John Doe, of Anywhere, Ga., and Joan Doe of Someplace, Ga.
Parent 1 Hometown and Zip:
Parent 2 Full Name:
Parent 2 Hometown and Zip:
High School, City, State, and Graduation Year *

Other Colleges or Universities Attended and Degrees:

Your Local Hometown Daily Newspaper and City *

Your Local Hometown Weekly Newspaper and City *

VSU Major, Minor, and Expected Graduation Date *

Activities You've Been Involved in at VSU:

Other Information:

Security Code *