Name: _____________________________________________

Cougar ID #: ___________________________

Address: ______________________________________________________

Phone: _______________ E-mail: ______________________

Technology/Major: _______________________

High School Attended: ___________________________

Colleges other than CSCC: _________________________________________

Experience Involving Speech Presentation Skills:

(Debate Tournament Participation, Acting, Competitive Speech/Forensics, Social Organizations, Toastmasters, etc.)

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High School and College Literature and Performance Courses:

Course Name Year Optional: Grade Textbook Instructor

_________________ ____ ____ __________ ________

_________________ ____ ____ __________ ________

_________________ ____ ____ __________ ________

_________________ ____ ____ __________ ________

Other Literature or Performance-related Experience:

______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________