Roosevelt Scholars Passport - Student Submissions

Roosevelt ScholarsRoosevelt Scholars Passport - Student Submissions

After you have attended, please submit here:

1) A brief write up of the event below - speaker(s) and major points indicated with bullets.

2) If this was an event at Roosevelt House, please upload a PDF of the event program with YOUR NAME written clearly on the front below

3) Separately and in addition to #2, if this was an event at Roosevelt House, please turn in the HARD COPY of the event program with YOUR NAME written clearly on the front to my mailbox in 812 East (not a typo - my mailbox is in 812 East)

Name Name * First Last
EMPL ID *
Email *
Cell Phone Cell Phone * - ### - ### ####
Student status *
NAME of Event *
Date of EVENT (not today's date) Date of EVENT (not today's date) * / MM / DD YYYY
Write up *
If this was an event at Roosevelt House, please upload a PDF scan of the program with YOUR NAME written clearly on the front, and then turn in the HARD COPY to my mailbox in 812 East

Maximum file size: 3MB.

Attach Files