Achievement Record: Missing Student Activity Information Form

Date*

MonthDayYear

Full Name*

First NameLast Name

E-mail*

Class Year*

Stonehill ID#*

Select the name of the one or more activities or committees using the following drop-down boxes. And, if you were an officer of a club, organization or committee, please select the activity in the drop down box and enter the leadership title in the corresponding space provided, if applicable.

Activity 1*

Leadership Position for Activity 1

(if applicable)

Activity 2

Leadership Position for Activity 2

(if applicable)

Activity 3

Leadership Position for Activity 3

(if applicable)

Activity 4

Leadership Position for Activity 4

(if applicable)

Activity 5

Leadership Position for Activity 5

(if applicable)

If the Activity drop-down does not list your specific activity, please email Patty Mead at pmead@stonehill.edu