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.
First Name Last Name
Social Security Number Student ID
Current Local Address
City State Zip
Local Telephone Email Address
Semester and year you plan to
If in a certification program,
Curry School Advisor:
I. Academic Awards and Honors (note that lines expand to accommodate content)
Award or Honor Awarding Institution Date
II. Co-curricular Activities (note that lines expand to accommodate content)
Student Organizations Leadership role/responsibility Date
Professional Organizations Leadership role/responsibility Date
Service Organizations Leadership role/responsibility Date
Special Talents or Interests - including athletics, music, & hobbies
Products, publications and/or presentations made (include full citation)
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.