* First Name:

* Middle Name:

* Last Name:

* Username/Student Number:

* Address:

* City:

* State:

* Zip:

* Cell Phone:

* Email:

* Date of Birth (Month Day Year):

* Gender:
Male Female

* Have you ever been convicted of a crime?
Yes No

* Are you graduating from LCC in Spring 2015?
Yes No

* Degree/Certificate Program:

* GPA:

* Why do you need a Graduate Career Makeover?

* Why do you feel you should be chosen as the winner?

* What were your greatest accomplishments while at LCC?

* Do you belong to any organizations or affiliations?
Yes No

* Have you secured a job after graduation?
Yes No

If so, with what campany and where is it located?

What are your professional goals?

Any additional comments?