* = Required

AIB ACADEMIC ALL-STAR

AIB College of Business and Mediacom Connections Channel 22 have teamed up to provide recognition to Iowa High School Juniors and Seniors who exhibit academic excellence and involvement in their high school or local community. Please provide the following information to be considered for recognition as an Academic All-Star! Winners are selected weekly and are featured during the half-time of the Iowa High School Football games featured on Mediacom Connections Channel 22.

* First Name Middle Name * Last Name

* Preferred Name * Gender MaleFemale

* Permanent Address

* City * State * Zip Code

Home Phone * Cell Phone

* E-mail Address * High School * Graduation Year

* High School GPA * ACT Score

* Hometown

Parent(s') Name(s)

In a brief paragraph, please tell us why you should be selected as an Academic All-Star! Feel free to share information about your high school and community involvement.

To be considered, please e-mail a photo for use on Mediacom Connections Channel 22 to admissions@aib.edu. Photos will only be used if you are selected as an Academic All-Star!

Please check this box if you agree to allow AIB College of Business to release your information and photo to Mediacom Connections Channel 22 for use in broadcast.

Please answer the following survey questions:

Do you plan to attend college? YesNo

If yes, please indicate where or mark undecided Undecided

What degree level do you wish to pursue? (check all that apply) Associate DegreeBachelor's DegreeMaster's Degree

What field of study to you plan to major in? (check all that apply) Accounting Business Administration Closed Captioning Communications and Design Court Reporting Finance General Studies Information Technology Insurance