Please complete the below listed information for each employee earning
a 25-year award. This information must be submitted to the Faculty/Staff
Newswire by a human resources representative. (This includes human resources
representatives, human resources officers and directors of business
Employee's first name
Employee's middle name (optional)
Employee's last name
25-year anniversary date:
Please select one:
The 25-year award recipient has been given the name and contact information for the area (college, campus, department, etc.) photographer. The area photographer will submit the photograph to Melissa Rugh at email@example.com.
A professional-quality photo of the 25-year award recipient will be e-mailed to Melissa Rugh at firstname.lastname@example.org.
The 25-year award recipient is not interested in having his/her photo
appear in the Faculty/Staff Newswire's 25-year award section.
Please simply list the employee's name, title and unit in this section.
The 25-year award recipient is not interested in having any information regarding
their 25-year award published.
Please provide your name, e-mail address and phone number so that we
may contact you if we need additional information:
Phone number: Area Code:
If you have any questions, please call Melissa Rugh at (814) 865-7517 or
Please complete all fields before you submit this form.