Witkin Award for Academic Excellence
Reporting Award Winners
Important information How to Report Winners Qualifying Courses

Please provide the following information for each award winner. Submit the information by e-mail or on a floppy disk in Word or Word Perfect format. An electronic copy of this form can be e-mailed to you. Contact John.hanft@thomsonreuters.com

Date: _______________

School name and address:

_________________________________________

_________________________________________

_________________________________________

_________________________________________

Form submitted by:

Name: ___________________________________

Phone: ___________________________________

e-mail: ___________________________________

________________________________________________________________________________________________

Provide the following information for each award winner. Please use the following chart, if possible. Please do not use all caps. Please list the names as they will appear on the certificate, with first name, middle initial, last name.

     Student Name:                          Course Title:                               Term or Semester:

1. _______________________     _____________________     _______________________

2. _______________________     _____________________     _______________________

3. _______________________     _____________________     _______________________

4. _______________________     _____________________     _______________________

5. _______________________     _____________________     _______________________

6. _______________________     _____________________     _______________________

7. _______________________     _____________________     _______________________

8. _______________________     _____________________     _______________________

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Last updated
Thursday, April 12, 2012