Press Release Request Form

Get recognized for your induction into Phi Theta Kappa! Simply fill out the form below, and once it is processed, the appropriate information will be e-mailed to the newspaper of your choice!

See an example of the Press Release.

Member Name: %%MEMBERNAME%% %%ERRORS%%

TIP: Call your local newspaper and ask for the e-mail address of the person who receives student recognition press releases.

Your Newspaper Contact's E-Mail Address:
Example: contact@newspapername.com. NOT www.newspapername.com

Your Newspaper's Title:

Your Newspaper's Address:

City:

State:

Zip:

Your Email Address:

Current information regarding your graduation date and major assists senior institutions in locating members eligible for over $35 million in Phi Theta Kappa transfer scholarships. If you do not know your exact graduation date, use a close approximation or the date you will complete your coursework at your current college.

Graduation/Transfer Date:  Month:   Year:

Current Major: 

OPTIONAL PERSONAL INFORMATION:

This information is not required for the press release, but will be included if you submit it.

Your Gender:

Why do we need to know your gender? The Press Release is automatically written by a computer program. Giving us this information will ensure that the sentences of the release are worded properly. For example: "Jane is the daughter of David and Karen." "Tom is the husband of Ellen."

Male      Female

Your Hometown:

Your Parents' Name(s) as you would like it to appear in the Press Release. Leave blank if not applicable.

Your Parents' place of residence -- City and State only -- as you would like it to appear in the Press Release. Leave blank if not applicable.

Spouse's Name as you would like it to appear in the Press Release. Leave blank if not applicable.

Your Spouse's place of residence -- City and State only -- as you would like it to appear in the Press Release. Leave blank if not applicable.

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