Parent of the Year Nomination

Applications and essays must be received by September 24 at 10:00 a.m. EST

Student Name

Students E-Mail Address

Please select the appropriate student status

Student ID

Student Local Phone

Student Cell Phone

Student Address

Campus Post Office Box # - if applicable

Residence Hall and Room # - if applicable

Parent Information

Name of Parent(s) Being Nominated

Address of Parent(s) Being Nominated

Phone # of Parent(s) Being Nominated

EMAIL of Parent(s) Being Nominated

Please Tell Us Why Your Parent(s) Should Be The Parent Of The Year

If your parent is selected may we read selections from your essay during the presentation:

Yes
No

If my nomination is selected, I grant permission for any photos taken during the award presentation to be used for future publicity for the Parent of the Year Award, and Family Weekend publications. I understand that the University of Louisville may copy or duplicate my entry for future use in publications or other mediums for marketing purposes with no compensation to me.

Student Signature

Are you a robot

Dean of Students

Parent of the Year Nomination