Application for Fall, 2015 Words That Changed History Day November 5, 2015 LRC-131

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Application for Fall, 2015
Words That Changed History Day
November 5, 2015
LRC-131
Each Finalist will receive a $100.00 VISA Card and a Certificate
The application deadline is October 23, 2015
Audition dates are October 27 and 29, 2015
(*Required)
*Date of Application:___________________________________
*7-Digit Student ID Number:_____________________________
*Name:______________________________________________
Address:_____________________________________________
*Preferred Phone Number:_______________________________
*Email:______________________________________________
*Speech Selected for Contest:
First Choice:__________________________________________
Second Choice:________________________________________
Third Choice:_________________________________________
Submit Completed Application to Dr. Gary Wilson by October 23, 2015, LRC, Suite A, Office #220
or mail to Dr. Wilson at gwilson@com.edu
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