Nomination Form

Enter the name of the advisor you are nominating: (Required)

Eligibility Requirements

A full-time faculty member whose primary advising responsibility is advising undergraduate students.
A full-time faculty member whose primary advising responsibility is advising graduate students.
Advisor/Coordinator/Counselor or Administrator whose primary and current job responsibility is advising students.

Nominee Category (Required)

Undergraduate Faculty Academic Advisor
Graduate Faculty Academic Advisor
Professional Academic Advisor

Nominee's Title

Nominee's Department/school/college (Required)

Nominee's Email Address (Required)

Nominee's work phone number

Relationship: (Required)

Please indicate your relationship to the advisor you are nominating.

Advisor's Colleague
Advisor's Supervisor
Advisor's Parent or Family Member
Advisor's Student or Advisee
Other

Enter your name: (Required)

Enter your e-mail address (Required)

Enter your phone number:

Enter your street address (Required)

Please use campus mailing address if one is available. Otherwise, please enter your residential address. Address information is needed to send information regarding the award reception next spring.

Enter your city, state and zip code (Required)

It is the nominator(s) responsibility to ensure that additional support letters are submitted by the deadline, January 3rd, 2011.

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