Your accomplishments and successes as a National University student are very important to us, now and after you have graduated. We appreciate you taking a few minutes to complete this form.

News media—particularly local hometown newspapers—are often in search of human interest stories. Our own news media— including the National University website, Network newsletter and Vision magazine—are always on the lookout for outstanding and compelling stories about students. Publicity is not guaranteed, but it is our practice to notify the media when a potential newsmaker exists.

To download a printable version of this form, click here.
Upon completion, fax this form to: (858) 642-8705.

First Name *
Last Name *
Student ID *
Date of Birth
(mm-dd-yyyy) *
Day Phone
Evening Phone
Email Address *
Address *
Address 2
City *
State *
Zip Code *
Hometown Newspaper(s)
National University School attended *
Campus *
Degree earned *
Current Employer
Position
NU Accomplishments
Any Adversity You Have Overcome?
Memberships and Affiliations
Professional Accomplishments
Additional Remarks
   
*    By checking this box, I understand that this information and these photographs become the property of National University and the National University System to be used for promotional purposes.