Submit Hometown Release
Hometown Release Form
Email Address (*)
Local Phone (*)
Select Your County...
Van Buren County
Names of Parents, Grandparents, or Guardians and the towns in which they live:* (Be specific as to how you wish to refer to your parents and include their first names. If you are married, please list your spouse's name) (*)
Award, honor, scholarship, or recognition for which this release is to be written:* (include details describing why you won the honor or award) (*)
Other Awards or Honors
Extracurricular activities, clubs, memberships in campus or community organizations: (include offices held, if any)
Plans following graduation
Note: Any news releases are prepared for local media and/or newspapers in your home county. You may request releases be sent to a different county if, for example, your parents live in two different communities or your grandparents live elsewhere. Please note any additional requests here
I authorize Tennessee Tech University's Office of Public Affairs to release this information to any media outlets.
As an electronic signature, please provide your initials here: (*)
Please Enter the Following Numbers