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

Units