Tennessee Tech University || Hometown Releases

Name*:		Local Phone*:
Email*:		Other Phone:
Major*:		Classification*: FR SO JR SR
Hometown*:		County*:
High School*:		Graduation Year*:
Names of Parents, Grandparents, or Guardians and the towns in which they live:* (Be specific as to how you wish to refer to your parents and include their first names. If you are married, please list your spouse's name)
Award, honor, scholarship, or recognition for which this release is to be written:* (include details describing why you won the honor or award)
Other Awards or Honors:
Extracurricular activities, clubs, memberships in campus or community organizations: (include offices held, if any)
Plans following graduation:
Note: Any news releases are prepared for local media and/or newspapers in your home county. You may request releases be sent to a different county if, for example, your parents live in two different communities or your grandparents live elsewhere. Please note any additional requests here:

I authorize Tennessee Tech University's Office of Public Affairs to release this information to any media outlets. As an electronic signature, please provide your initials here: * Date: *

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