Please complete this form and then click on Submit.

If selected as a finalist, you will need to verify your GPA
and supply other materials.

Please fill in all fields. Incomplete forms may be disqualified.

Your name
Your home address
Zip code
Your address at school
School address 2
Zip code
Your phone number
Your e-mail address

Grade Point Average (entire collegiate career to date)
Academic Major
Expected Graduation (month/year)
I am a:  Sophomore Junior

To be eligible, you must either be a resident of the Delaware Valley or attend an accredited undergraduate college or university communications or associated program in the Delaware Valley.

My home address is in the Delaware Valley
My school is in the Delaware Valley
I both live and attend school in the Delaware Valley

Work experience or Internship related to your major. Also include any academic awards or honors you have received or any school or community volunteer efforts in which you have been involved (THIS IS IMPORTANT!):


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