Student
News & Information Form

Complete the form below to submit a student news & information item to Union's Office of University Communications.  If you have any questions, contact Tim Ellsworth, Director of News & Media Relations, at (731) 661-5215 or by e-mail. Your news item will be processed as soon as possible and distributed to the appropriate media.

Valid source information must be given to verify this news item.  Thank You.

Items with a are required

Contact Information:
Who's completing this news submission form and who can we contact for more information about this item?

Name:

Campus Box:

E-Mail Address:

Telephone Number:

News Information:
Who does the news item you are submitting concern?

Title Mr. Mrs. Miss Ms. Dr. Rev.

Student First Name:

Student Last Name:

Current Classification:
Graduate Student Senior Junior Sophomore Freshman

Major:

Age:

Address 1:

Address 2:

City:

State: - Please Select One - Not Applicable Alaska Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana Nebraska North Carolina North Dakota New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming

Zip Code:

High School:

Year Graduated from High School:

Parents:

Parents Address (Only city and state necessary):

News Item (Include specific details...who, what, when, where, and how):

Campus Involvement/Awards (Include membership and offices held):

Media Outlets (Identify names and complete address of print and broadcast media):

Any Comment or Note?