Email to: emuhonors@emich.edu Return to: The Honors College
Starkweather Hall
Eastern Michigan University
Ypsilanti, MI 48197
Name:
Student Number:
E My.emich email: @emich.edu
Which Honors Experience category will this satisfy? (circle one) Leadership/Civic Engagement Intellectual/Cultural
Date(s) of Honors Experience: Is this part of a series of intellectual/cultural events? Yes No
What did you do/attend to fulfill the Honors Experience requirement?
Student Signature Date
Supervisor’s Signature Date
Signature of Honors Staff indicating Completion Date
Within one month of completion of this Honors Experience, this form plus clearly labeled documentation (including name, student number, and date(s) of program) must be returned to the Honors College Office.
DOCUMENTATION OF COMPLETION AND REFLECTION PAPER MUST BE ATTACHED TO FINAL FORM
COMPLETE THIS SECTION IF PRE-APPROVAL IS REQUIRED
If pre-approval is required, on a separate sheet of paper, indicate how the experience meets one of the following goals:
1. Develop leadership skills of Honors students
2. Enrich the intellectual lives and minds of Honors students
3. Help create a sense of community among Honors students
4. Give Honors students broad exposure to cultural diversity and enrichment
5. Enhance the international experience of Honors students
Signature of Honors Staff indicating Pre-Approval Date