Name of nominee

Nominee telephone

Nominee Email

Nominated By

Your Email

Your Telephone Number

Nomination Rationale

How has the nominee demonstrated their service to student organization(s) and the campus community?

Describe any significant contributions the nominee has made towards the betterment of the campus and/or the surrounding community.

What activities (on- and off-campus) has the nominee been involved with?

In what ways has the nominee displayed strong leadership behaviors and encouraged leadership development among others?

If not already addressed, please describe why the nominee is deserving of this award.

Submit