2012 Honors Convocation
Student Honoree Form
IMPORTANT INSTRUCTIONS – PLEASE COMPLETE UPON RECEIPT – Submission deadline is Wednesday, February 15, 2012.
The information you provide on this form is used for the 2012 Convocation Program. Type ALL of the information requested on the fields below. You may use the TAB key to move from one field to another. After you and the college Dean sign the Honoree Form, please send this form (as an attachment) to the Office of University Relations to . If you have any questions, please contact the Office of University Relations at 747-8244 or at .
NOMINATING DEPARTMENT:
(Note: Form to be completed electronically and as you begin to type, the blank fields will expand to fit your responses)
1. OUTSTANDING GRADUATE STUDENT AND OUTSTANDING SENIOR BY MAJOR
A. One academically outstanding graduate student who graduated in Summer 2011, Dec. 2011, or will graduate May 2012 – only one student per major. (Please use additional forms as needed)
Student Name: (Last) (First) (MI): Major:
Address: City: State: Zip: UTEP E-mail: Alternate E-mail:
If applicable:
Student Name: (Last) (First) (MI): Major:
Address: City: State: Zip: UTEP E-mail: Alternate E-mail:
If applicable:
Student Name: (Last) (First) (MI): Major:
Address: City: State: Zip: UTEP E-mail: Alternate E-mail:
B. One academically outstanding senior by major who graduated in Summer 2011, Dec. 2011, or will graduate May 2012 – only one student per major. (Please use additional forms as needed)
Student Name: (Last) (First) (MI): Major:
Address: City: State: Zip: UTEP E-mail: Alternate E-mail:
If applicable:
Student Name: (Last) (First) (MI): Major:
Address: City: State: Zip: UTEP E-mail: Alternate E-mail:
If applicable:
Student Name: (Last) (First) (MI): Major:
Address: City: State: Zip: UTEP E-mail: Alternate E-mail:
2. DEPARTMENT AWARDS
Department award named in honor of someone – do not include scholarships – recipient does not necessarily have to be graduating in the 2012 academic year.
Award Title:
Recipient’s Full Name (First Name, MI, and Last Name): Major:
Address: City: State: Zip: UTEP E-mail: Alternate E-mail:
3. OUTSTANDING GRADUATE AND UNDERGRADUATE THESIS (BY DEPARTMENT)
A. One outstanding graduate thesis by department from a student who graduated in Summer 2011, Dec. 2011, or will graduate May 2012 – only one thesis nomination per department.
Student Name: (Last) (First) (MI): Major:
Address: City: State: Zip: UTEP E-mail: Alternate E-mail:
B. One outstanding undergraduate thesis by department from a student who graduated in Summer 2011, Dec. 2011, or will graduate May 2012 – only one thesis nomination per department.
Student Name: (Last) (First) (MI): Major:
Address: City: State: Zip: UTEP E-mail: Alternate E-mail:
4. OTHER STUDENT AWARDS
Other Student Award - The award is based entirely on academic achievement and is administered through the department or Graduate School.
Award Title:
Recipient’s Full Name (First Name, MI, and Last Name): Major:
Address: City: State: Zip: UTEP E-mail: Alternate E-mail:
5. DEPARTMENT HONOR SOCIETIES
Only those Department HONOR Societies that are currently active and have registered with UTEP Student Development Center for the Spring 2012 Semester will be included in the Honors Convocation program. Direct your questions about current status to the Student Development Center at 747-5670.
Honor Society Name:
President (Name)
Address: City: State: Zip: UTEP E-mail: Alternate E-mail:
Name of Advisor(s): Department: Ext: UTEP E-mail:
If applicable:
Honor Society Name:
President (Name)
Address: City: State: Zip: UTEP E-mail: Alternate E-mail:
Name of Advisor(s): Department: Ext: UTEP E-mail:
6. SIGNATURES
The information will not be accepted without the Dean’s signature (electronic signatures are accepted).
Signature: Date:
Department/Program Head
Signature: Date:
Dean
COMMENTS
.
Return by Wednesday, February 15, 2012
This form can also be found online at: www.utep.edu/universityrelations follow the link for 2012 Honors Convocation then click on the link for Department Chairs and you will find this form as part of the listed links.