American Experience Project Application

American Experience Application Form 2004-2005

Name of Project/Presentation: ___________________________________

Members of Group:

______________________________

Circle Concentration:

Virginia History American History

Virginia Literature American Literature

Virginia Politics American Politics

Virginia Music American Music

Virginia Art American Art

Virginia Anthropology American Anthropology

Explain, in one paragraph, exactly what you would like to do:

_____________________________________________________________________________________

Why would this benefit the school and the students?

______________________________________________________________________________________

What tools/equipment/accessories do you need for this program?

______________________________________________________________________________________

Primary Contact Information

Name ___________________________________

E-mail __________________________________

Year in School_____________________________

Telephone_________________________________

Major(s) __________________________________

PLEASE RETURN THREE COPIES OF THIS FORM TO THE MICAH INITIATIVE BOX LOCATED

BEHIND THE STUDENT ACTIVITIES DESK IN TYLER HAYNES COMMONS. WE WILL CONTACT

YOU AS SOON AS WE HAVE MADE A DECISION.

Last Updated (8/22/04)