Emeritus Status Application

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Please fill out the form completely to submit your application for emeritus status consideration.

Name

Address

City

State

Zip Code

Phone

Years at Madison College

Summarize your specific contributions to Madison College (In a minimum of 150 words, please describe your specific contributions to teaching, scholarship, student development, committee work, advising, co-curricular activities and community involvement).

How do you plan to pursue lifelong learning, writing, speaking, teaching, and other civic and academic-related pursuits, connect with the Madison College community, and other support the ongoing mission of the college? (150 word minimum)

Please describe (in a minimum of 150 words) why you are applying for emeritus status.

Is there anything else you'd like us to know about you or why you are applying for emeritus status?