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Title of work:

Student Name:

Address:

City:

Zip Code:

Phone number#

Email:

Name of teacher, semester, and course for which this paper was written:

In the space below, please write from one to three sentences about yourself (in third person). Include whatever you think readers may be interested in: your high school or college experience, major subject, job, career plans, hobbies, unusual experiences or background, etc. You may also comment on your essay, its relationship to your experience, your source of inspiration, etc. (This statement may be subject to editing.) Please include your email address and phone number at the end of the statement.
	

Examples:“(Name) is full-time homemaker and the mother of three and a Sunday school teacher in her church and community.  She is also a returning part-time Wright student majoring in elementary education.”
	

“(Name) is a 2016 graduate of (name of high school,) where he enjoyed playing basketball.  He plans to graduate from (name of school) in (year) and transfer to the University of Illinois at Chicago to earn a degree in (subject).”
	

The Symposium Release Form

Upload File (Word Document or Rich Text Format only)

By typing my initials and ID below, I understand that I agree to the terms of submission. I certify that the essay submitted to the Great Books Symposium Journal is my own work and that I have carefully documented my sources to avoid plagiarizing other writers’ words or ideas. I agree to its publication in a future issue of the journal. I understand that I may be asked to revise the work before it is reconsidered for publication, and I agree to respond to requests for revisions in a timely manner. Moreover, I understand that I will not receive any payment or royalties from the City Colleges of Chicago for the publication of my work(s).
	

Your Initials

Your Student ID

Need more information or clarification? Contact Professor Michael Petersen at mpetersen@ccc.edu