Academic Honor Society Application

Name(Required)

First Last

Student ID Number(Required)

If you have forgotten your ID Number, you can look it up here.

Email(Required)

Date of birth(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone(Required)

Degree program(Required)

I have earned 12 or more credits toward my associate degree, or earned 6 or more credits towards my technical diploma.

Yes

Expected graduation date:(Required)

Select which location(s) you attend:(Required)

Fond du Lac

Beaver Dam

West Bend

Online

Signature(Required)

First Last

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Phone

This field is for validation purposes and should be left unchanged.