Student Information

Name

PSU Email

Phone Number

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Address

Major

# of Years Attending PSU

Parent/Guardian Information

Family Member #1

Name

Relationship

Pitt State Alumni

Address

Family Member #2

Name

Relationship

Pitt State Alumni

Address

Family Member #3

Name

Relationship

Pitt State Alumni

Address

Family Member #4

Name

Relationship

Pitt State Alumni

Address

Sibling Information

Sibling #1

Sibling 1 Name

Sibling 1 Age

Pitt State Alumni

Questions

Respond to each question in as much detail as possible. The Honorary Family will be selected based on a review of your answers.

1. Reflect on past family experiences and relationships with your parents, siblings, etc. and how these have impacted your school spirit.

2. Highlight your involvement, as well as your family’s involvement, in your hometown community outside of the course of employment (if applicable).

3. Explain the encouragement you have received from your family to achieve a higher education which may include stories or special memories at Pittsburg State University.

4. Highlight your involvement, as well as your family’s involvement, at Pittsburg State University outside the course of employment (if applicable).

5. Why do you believe your family should be chosen as the Honorary Family?

Nominations are due by Monday, September 8th. If you have any questions, feel free to contact Lauren Baldwin at [email protected] or 620-235-4930.

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