2019 ODSA Hall of Fame Application
This is the application for the ODSA Hall of Fame. The application is not complete until a picture has been submitted to the ODSA Board. Please see confirmation page for details. If you have any questions or concerns, please contact Penny Walston by email at penny.coberly@tulsacc.edu or by phone at 918-595-7532. The deadline is January 18, 2019!
Email address *
Students Name (First, Middle Initial, Last) *
Mailing Address (Street/PO Box, City, State Zip Code) *
Phone Number *
Email *
Hometown/State *
Where is your TRIO Program housed? *
In what federal congressional district is your TRIO program located? *
Choose your TRIO Program *
Current Grade Level *
Choose one question and answer it in 150 words or less. *
Type the answer to the question above here. *
Please upload the picture you would like to accompany you in the Hall of Fame section. *
Required
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service