Name:   Local Address:
Phone:

Name of Student Involvement Area (Organization) You Advise or Supervise:

1. Please indicate your involvement over this past semester with your student group(s) (student organization, athletic teams, performing groups, employment area):

2. Using specific examples, please indicate how you have personally grown and developed through your experience with your student group(s):

3. Using specific examples, please indicate how your student group members have grown and developed through your experience with them:

If you have questions or comments, please contact the Campus Activities and Recreation Office at 346-4343.