Student of the Month Nomination Form

Please complete the following fields to nominate a student for this award.

Upon submission, the form will be sent to Chuck Dewald, assistant teaching professor of English and Multidisciplinary Studies degree program coordinator.

The Faculty-Student Relations Committee will vote to decide the winner.

First name of student nominee:

Last name of student nominee:

General category for nomination (Check all that apply)

Civility

Academic Improvement

Community Care and Involvement

Personal Achievement Over Obstacles

Other (please specify below)

Reason for nomination (Please be specific):

First name of nominator (optional):

While this information is optional, please complete this section in case the committee has questions about the nominee.

Last name of nominator:

Nominator's email:

Nominator's cell phone number:

Date submitted:

Note: The date should reflect a date prior to or the last date of the month in which the student is being nominated for the award.