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Office of Fellowships & Scholar Programs
Press Release Form for Graduate Students and Alumni
Please complete the following information for campus and community news and information releases regarding your scholarship
and tenure at USC. Return this form immediately to the Office of Fellowships and Scholar Programs, ofsp@sc.edu.
Name ________________________________________________________________________________________________
Social Security Last Four Digits ________________________ Birthdate ____________________________________
Current Address (include Zip Code)_______________________________________________________________
Current Phone________________________________
Cell Phone (
)______________________________
Email ________________________________
High School (include city and state):________________________________________________________________________
Undergraduate College __________________________ Major(s)_________________________________________________
Graduation Year ___________ USC Honors College Student? Y______ N_______ USC Capstone Scholar? Y______ N______
Please check one
if applicable:
Carolina Scholar ______
Stamps Carolina Scholar ________
McNair Scholar ______
Horseshoe Scholar ______
Hamilton Scholar ______
Presidential Scholar _____
Graduate School ________________________________ Graduate Program, Degree, & Date ___________________________
This press release is in reference to the following award:________________________________________________________
Description of activities you are/were involved in on campus or in the community, including research:
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
Current Career Goals or Interests: ___________________________________________________________________________
Other scholarships, honors, and publications:___________________________________________________________________
________________________________________________________________________________________________________
_________________________________________________________________________________________
Family Information
Mother's Name:____________________________________
Father’s Name: ___________________________________
Address__________________________________________
Address__________________________________________
City_________________________State_____ Zip _______
City_________________________State_____ Zip _______
Newspaper(s) to receive information__________________________________________________________________________
By signing this form, I agree to allow the release of this information by the USC Office of Fellowships and Scholar
Programs and USC Office of Communications. Information may be used in a variety of mediums including but
not limited to broadcast, print, Internet, and others.
Signature ____________________________________________________________________Date _______________________
Press Release Form.doc – May 2013