Middle Tennessee State University
Student Recognition Awards
Community Service Award Application
Name ____________________________
M#________________________________
Major ____________________________
Credits Earned ______________________
Expected Date of Graduation _________
Cumulative GPA_____________________
Local Address __________________________________________________________
Permanent Address ______________________________________________________
Email____________________________
Phone_____________________________
What are your significant achievements and contributions to MTSU and/or community?
How did this contribution to the community impact your life?
How would you explain the benefits of volunteerism to someone who does not participate
in community service?
Along with your application, please submit:
 An essay (not to exceed two typed, double spaced pages) describing the
circumstances that make you a strong candidate for this award (as explained in the
award description). Possible items to include are your additional responsibilities
and involvement in volunteer and extracurricular activities that involve service to
the community.
 Two (2) letters of support from MTSU personnel or external community
members.
Submit your application, essay, and letters of recommendation to the Student Organizations &
Service Office in Student Union 330 or MTSU Box 39.