| GENERAL INFORMATION |
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 | Enter a valid phone number. Example: 123-456-7890 |
 | Enter a valid phone number. Example: 123-456-7890 |
 | Enter a valid email address. Example: name@company.com |
| Local Address including city, state, and zip code (Please include campus mail box) |
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| Permanent Address including city, state, and zip code (Parents' address) |
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| Please list one song you would like played during the slide show as the class theme song. Include title and artist: |
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| The following information will be used to create your African name and interpretation.
GENDER |
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| Format For Birthday:
mm/dd/yyyy DATE OF BIRTH |
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| Day of the week you were born |
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| Achievements and Contributions:
Please list some of your contributions at LMU or to the African American community. For example, did you start a club on campus or were you a member of a club? Did you receive any scholarships or special awards? |
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| Kente Naming/Robing:
Please list three characteristics that best describe you. Please choose three characteristics carefully, all jokes aside. These will be used in the selection of your African name during the Naming/Robing portion of the ceremony. Please list in order of preference. |
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| PROGRAM INFORMATION |
| Reflections:
You will have an opportunity to thank those special people who have helped and supported you with your education at LMU. This can be a variation of family members, friends, church members, faculty and/or staff. These acknowledgements will be included in the program. NO MORE THAN 50 WORDS PLEASE! If necessary, reflections will be edited for content and clarity. |
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| Honoring Faculty and Staff; we would like to recognize those who made special contributions to the African American student community. Please list one faculty member who you feel deserves special recognition. |
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| Please list one staff member who you feel deserves special recognition. (ONE FACULTY AND ONE STAFF WILL BE SELECTED BASED ON CONSENSUS OF THE CLASS). |
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| CHECKLIST |
| GRADUATION FEE AND PHOTOGRAPHS |
 | | I will submit my $75 graduation fee by cash, money order, or check payable to LMU/OBSS (which helps cover cost of reception, printing, design of program booklet, decorations, speaker honorarium, etc.) to OBSS (Malone 301) by JANUARY 23, 2009. | | I have included pictures for the printed program. Pictures must be no smaller than 2 1/2 x 3 1/2 inches, a headshot of the graduate only (no group pictures and no objects in the background). Pictures can be turned into OBSS (Malone 301)or gbuck@lmu.edu | | I understand that if my payment and photographs are not submitted to OBSS by January 23, 2009, then I will forfeit my application in this years' ceremony. |
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