Name

Title

Department

Date you joined KSU

Positions held prior to KSU

Date of Birth

Place of Birth/Hometown

Names and addresses of parents (if living)

Date and Place of marraige (if applicable)

Spouse's name and Hometown (if applicable)

Is spouse a KSU graduate

Please list children's names and dates of birth (if applicable)

Education:

Secondary schools. date of graduation

Colleges, universities and graduate schools attended

College degree granted, major, year, institution

Military Experience:

Branch of service

Length of Service

Rank

Honors

Engagements

Honors and Organizations:

College honors, including honor societies, fellowships

Professional societies, offices held, with dates

HonoraryDegrees (include degree, year, institution)

Work at K-State:

Promotions, dates of advancement

Principal committees and other nonintructional work

Special research at K-state or elsewhere

Books, bulletins or pamphlets of which you are the author

Additional Comments

Kansas State University • Manhattan, KS • 66506 • 785-532-6011

March 15, 2007