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Davies Center Service Award Application

PERSONAL INFORMATION
Full Name
Local Address
(if applicable)
City/State/Zip
   
Home Address
City/State/Zip
   
Home Phone
Cell
Work
Email Address
Major
Minor
Year in School Junior Senior
Number of semesters
at UW-Eau Claire

Number of years
working with the ball


DAVIES CENTER EMPLOYMENT HISTORY
Employer
Length
DESCRIPTION OF DUTIES

Describe how your work with the Viennese Ball in Davies Center has allowed
you to develop as an individual and a leader.

VIENNESE BALL WORK EXPERIENCE
Describe how your work experiences in Davies Center have contributed
to the production of the Viennese Ball.

STATEMENT OF INTENT
Explain why you should be selected for this award.

REFERENCES
List the names and addresses of two University Centers faculty/staff members who
can attest to your contribution to the Viennese Ball and to the quality of your work.
Name
Campus Address
Phone
Email

Name
Campus Address
Phone
Email

 

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