Your Information

Name

Male Female

Phone

E-mail

UMass Amherst Class Year or Graduate Student

Major

High School

High School Graduation Year

Mother's Name and Address

Father's Name (and address, if different)

Award Information

Award or Achievement

Contact Person for Award

Contact Phone

Contact E-mail

Hometown Newspaper

Name of Newspaper

Newspaper Address

Not a metropolitan paper such as the Boston Globe, Providence Journal, New York Times

Other Awards or Honor Societies

Please name any other awards, honor societies, etc., not mentioned above that you would like included in the write-up sent to your hometown newspaper