Distinguished Senior Award Application 2024

To submit an application, please complete this form by Friday, March 29, 2024.

Student's Name Student's Name * Title First Last Suffix
Student's E-Number *
Student’s Campus Address Student’s Campus Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Student’s Phone Number Student’s Phone Number * - ### - ### ####
Student’s EIU Email Address *
Student’s Major *
Student’s Minor
Number of Academic Hours Completed at EIU *
Cumulative Grade Point Average *
Student’s Expected Graduation Date *

Student’s Expected Graduation Date Spring 2024 Summer 2024 Fall 2024
Student’s Hometown Newspaper *
List student's campus organizations and activities *

Be sure to include dates of involvement and any leadership positions held.
List student's participation in organizations and activities outside the campus community while attending EIU *

Be sure to include dates of involvement and any leadership positions held.
List of honors and/or awards student received while attending EIU. *
Describe why you believe you should be considered for the Distinguished Senior Award. *