Fort Hays State University

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Application for the 2013-14 VIP Student Ambassador Group

Complete and submit application no later than 4:30 p.m., Thursday, Feb. 28.

Interview dates are March 6, 7 and 8. Schedule your interview now. If you prefer, you can schedule the interview after you have submitted the application.

Name:

Current Address:

Street:

City:

State:

Zip:

Phone Number:

E-mail Address:

Fall 2013 Classification:

Fr So Jr Sr

Major:

GPA (must be 2.5 or higher):

Hometown:

Last 4 digits of social security # (for verification):

List your college activities, organization memberships, awards, and honors received:

List your non-FHSU related interests, hobbies, and/or activities:

Please explain why you would like to become a member of the VIP Student Ambassador group:

List your current class schedule:

If you have a job, please list your work schedule:

Please upload a photo of yourself here. This will be used by the interviewers solely for identification purposes. Please name the picture 'your_name.'

References:

List the names and telephone numbers of two references and your relationship to each reference (preferably individuals on campus or in Hays):

Name:
Phone:
Relationship:
Name:
Phone:
Relationship:

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