Chancellor’s Award for Student Excellence Nomination Form
The Chancellor's Award for Student Excellence acknowledges students who have demonstrated student excellence in a variety of areas. We are seeking nominations from the campus community of students who have best demonstrated, and been recognized for, the integration of academic excellence with other aspects of their lives, which may include leadership, campus involvement, community service, arts, athletics and/or career achievement.
Only students graduating between June 2015 and May 2016 will be considered. All information must be typed on the form; handwritten copies will not be accepted. Only awards received while at current institution are applicable. (Awards from another college or high school should not be included.)
Nomination Packets must be submitted by Friday, January 29 at 4:00pm and include the following:
· Completed Nomination Form
· 2-3 Letters of Recommendation
· Resume – not to exceed 2 pages (optional)
Packets can be submitted electronically via email as a pdf file to or in-person to the Office of Community Development, College Union 203.
Nominee Name: Click here to enter text.
Graduation Month/Year: Click here to enter text. GPA: Click here to enter text.
Degree: Click here to enter text. Major: Click here to enter text.
Email Address: Click here to enter text.
Address (if selected, letter will be sent to this address): Click here to enter text.
City: Click here to enter text. State: Click here to enter text. Zip: Click here to enter text.
Hometown (city, state): Click here to enter text.
Please share a brief student biography (75 words or fewer):
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List the student’s top three accomplishments which will appear in the award ceremony program if chosen (50 words or fewer each)
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2. Click here to enter text.
3. Click here to enter text.
Areas of Accomplishment
For each category, list any awards, recognition or accomplishments that demonstrate excellence in the area of academic excellence. You may enter as many items as you wish in each category. It is not necessary to fill each category. Include dates and a brief description.
ACADEMIC EXCELLENCE
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LEADERSHIP
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CAMPUS INVOLVEMENT
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COMMUNITY SERVICE
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ARTS (VISUAL, PERFORMING AND WRITTEN)
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ATHLETICS
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CAREER ACHIEVEMENT
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OTHER
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Letters of Recommendation
Please indicate the name and title of any individuals writing a letter of recommendation.
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2. Click here to enter text.
3. Click here to enter text.
Resume (optional)
Please indicate if a resume, not to exceed 2 pages, will be included in the nomination packet.
Choose an item.
Any questions can be directed to Kim Piatt, Assistant Director of Community Development at or 595.395.2987