Student Resume & Information Form You must submit a completed form for each award for which you wish to be considered. If you have been nominated for an award, complete this form and return it to your faculty nominator. Each nomination will require a separate copy to be submitted and returned to the respective nominator(s). If you are nominating yourself for an award, you much submit this form along with up to two letters of recommendation from faculty members in support of your nomination. All application packets must be completed and delivered to Kirsten Hilliard in Room 169 by 4:00 p.m. on January 31, 2008. Note that all required materials must be included for your application to be considered. Check carefully to ensure the information submitted is accurate and complete. Personal Information First Name Last Name Social Security Number Student ID Address Current Local Address City State Zip Local Telephone Email Address Academic Information Semester and year you plan to graduate: Department Specialization If in a certification program, specify area: Curry School Advisor: Current GPA Achievements I. Academic Awards and Honors (note that lines expand to accommodate content) Award or Honor Awarding Institution Date 1 2 3 II. Co-curricular Activities (note that lines expand to accommodate content) Student Organizations Leadership role/responsibility Date 1 2 3 Professional Organizations Leadership role/responsibility Date 1 2 3 Service Organizations Leadership role/responsibility Date 1 2 3 Special Talents or Interests - including athletics, music, & hobbies Products, publications and/or presentations made (include full citation) 1. 2. 3. 4. 5. 6. 7. Add Additional Information Here: By submitting this form, I certify, on my honor as a student of the University of Virginia that the information I am submitting is accurate and complete to the best of my knowledge.
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