Note: Information provided in this Application must match information on your HALL OF FAME VERIFICATION FORM
NAME OF STUDENT
PERMANENT MAILING ADDRESS TO COMMUNICATE WITH YOU
Consent and Approval
I, the undersigned and/or Applicant to the Academic Hall of Fame, hereby give consent and approval to the Academic Hall of Fame to use without restrictions all the information and material, including my photograph and written material submitted in support of my application for membership. This use includes editing any submissions for clarity or to meet editorial needs, the free use of the information in marketing and advertising the organization both online, and offline and the use of the material for fundraising or for sale. I further consent and approve the Hall of Fame ownership of copyright to my Hall of Fame Essay and Hall of Fame Speech with the understanding that I, the member, am not precluded from using same for my personal use.
I CONSENT AND APPROVE *
I hereby attest that the information submitted in this application is factual and truthful, with a clear understanding that any false information submitted or presented to AHOF will be grounds for delisting and cancellation of my membership in the Academic Hall of Fame.