Online Medallion Round-up Form
Please read carefully as this information will be used to engrave your medallion and print your certificate.

Name:
FAU Email:
Concentration(s):
Thesis 1 Title:
Thesis Advisor(s):
Brief Synopsis of Thesis 1 (max 100 words):
Thesis 2 Title (if applicable):
Thesis 2 Advisor(s) (if applicable):
Brief Synopsis of Thesis 2 (max 100 words) (if applicable):
Favorite Honors College Memory (Family Safe Please - max 30 words):
How many tickets do you need for the Medallion Ceremony: (max 5)
How many seats do you want to reserve for the bus to go down to Boca?
Please enter up to 2 mailing addresses for the Honors College to mail Medallion Ceremony invitations.
Name of Guest(s) #1:
Address of Guest(s) #1:
Name of Guest(s) #2:
Address of Guest(s) #2:
Post-graduation Contact Information
Email Address:
Forwarding Address after you graduate:
Post-graduation Plans
Have you applied to and been admitted to a graduate or professional school?
Please select one of the following: Yes, I have applied and been admitted. I have applied and am waiting to hear from the school(s) I applied to. No, I have not applied.
Name of university or program:
Type of program (Masters, Ph.D, Professional Degree?):
Area of Study:
Employment Information
Have you already secured your post-graduation employment?		Please select one of the following: Yes No
Employer Name:
Industry:
Location:
Other Plans for after Graduation (max 30 words):
Comments/Questions:

Information about the Commencement Ceremony in Boca Raton.