Graduating Senior / Graduate Student Nomination Form

Candidate Information:

Graduating Senior Graduate Student
 
First Name
Middle Initial
Last Name
Home Address Street
City
State
Zip
Phone Number
Degree Program
Semester of Graduation Summer 2007
Fall 2007
Spring 2008

Academic Achievement

PSH Organization Involvement

Other Activities

Community Service

Memberships

Hobbies

Sports Teams

Employment While in College

How has Penn State Harrisburg influenced your life?

Nominator's Information:

First Name
Last Name
Middle Initial
Home Address Street
City
State
Zip
Phone Number
Relationship to Nominee
Date of Nomination

*A letter of recommendation must be included with the nomination. Please DO NOT send a resume.

Send Letters of recommendation to:

Alumni Relations Office - Penn State Harrisburg
W-110 Olmsted Building
777 West Harrisburg Pike
Middletown PA 17057

Fax: 717 - 948 - 6317
Email to hbgalumni@psu.edu