Section 1 of 4
Student Leadership Awards 2016 Nomination Form
The nomination deadline has been extended to Friday, March 25, 2016.
Student Leadership Awards DESCRIPTIONS can be found at go.uvm.edu/slifeawards
Student Leadership Awards DESCRIPTIONS can be found at go.uvm.edu/slifeawards
Phone Number:
Phone Number:
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Nominator Information
Nominator Information
(Your Information)
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Section 2 of 4
First Nominee
Name:
Name:
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Department or Major:
Department or Major:
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E-mail:
E-mail:
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UVM Affiliation
UVM Affiliation
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1.
Faculty
2.
Staff
3.
Student
4.
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Nominee's Name:
Nominee's Name:
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Pronouns Used By Nominee:
Pronouns Used By Nominee:
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Class Year
Class Year
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Time
1.
2016
2.
2017
3.
2018
4.
2019
5.
Other
6.
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Nominee's Local Address:
Nominee's Local Address:
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(If Known)
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Nominee's Phone Number:
Nominee's Phone Number:
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Nominee's E-mail:
Nominee's E-mail:
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What is your relationship to the student being nominated?
What is your relationship to the student being nominated?
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Award(s) Being Nominated For:
Award(s) Being Nominated For:
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Award descriptions can be found at go.uvm.edu/slifeawards (Please check all awards for which the student is being nominated)
Outstanding Achievement Award (FY, So., Jr. only)
Patrick M. Brown Leadership Award (FY, So., Jr. only)
Activism & Commitment to Justice Award (FY, So., Jr. only)
Environmental Citizen Award (All Students)
Spirit of Service Award (All Students)
Unsung Champion Award (All Students)
Sustained Commitment Award (All Students)
Think. Care. Act. (All Students)
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add "Other"
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Please explain (in 500 words or less) why you are nominating this individual for this specific award.
Please explain (in 500 words or less) why you are nominating this individual for this specific award.
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Please note that this will be the only documentation that the selection committee will see to make their decisions, so please be as specific as possible with your response.
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Would you like to nominate another student?
Would you like to nominate another student?
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1.
Yes
Continue to next section
2.
No
Continue to next section
3.
Add option
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Section 3 of 4
Second Nominee
Nominee's Name:
Nominee's Name:
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Pronouns Used By Nominee:
Pronouns Used By Nominee:
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Class Year
Class Year
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Date
Time
1.
2016
2.
2017
3.
2018
4.
2019
5.
Other
6.
Add option
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Nominee's Local Address:
Nominee's Local Address:
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(If Known)
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Nominee's Phone Number:
Nominee's Phone Number:
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Nominee's E-mail:
Nominee's E-mail:
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What is your relationship to the student being nominated?
What is your relationship to the student being nominated?
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Award(s) Being Nominated For:
Award(s) Being Nominated For:
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Award descriptions can be found at go.uvm.edu/slifeawards (Please check all awards for which the student is being nominated)
Outstanding Achievement Award (FY, So., Jr. only)
Patrick M. Brown Leadership Award (FY, So., Jr. only)
Activism & Commitment to Justice Award (FY, So., Jr. only)
Environmental Citizen Award (All Students)
Spirit of Service Award (All Students)
Unsung Champion Award (All Students)
Sustained Commitment Award (All Students)
Think. Care. Act. (All Students)
Add option
or
add "Other"
…
Answer key
(0 points)
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Please explain (in 500 words or fewer) why you are nominating this individual for this specific award.
Please explain (in 500 words or fewer) why you are nominating this individual for this specific award.
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Please note that this will be the only documentation that the selection committee will see to make their decisions, so please be as specific as possible with your response.
Answer key
(0 points)
Loading...
Would you like to nominate another student?
Would you like to nominate another student?
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1.
Yes
Continue to next section
2.
No
Continue to next section
3.
Add option
…
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Section 4 of 4
Third Nominee
Nominee's Name:
Nominee's Name:
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Pronouns Used By Nominee:
Pronouns Used By Nominee:
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Class Year
Class Year
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Date
Time
1.
2016
2.
2017
3.
2018
4.
2019
5.
Other
6.
Add option
…
Answer key
(0 points)
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Nominee's Local Address:
Nominee's Local Address:
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Date
Time
(If Known)
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Nominee's Phone Number:
Nominee's Phone Number:
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Date
Time
(If Known)
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Nominee's E-mail
Nominee's E-mail
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What is your relationship to the student being nominated?
What is your relationship to the student being nominated?
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Award(s) Being Nominated For:
Award(s) Being Nominated For:
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Award descriptions can be found at go.uvm.edu/slifeawards (Please check all awards for which the student is being nominated)
Outstanding Achievement Award (FY, So., Jr. only)
Patrick M. Brown Leadership Award (FY, So., Jr. only)
Activism & Commitment to Justice Award (FY, So., Jr. only)
Environmental Citizen Award (All Students)
Spirit of Service Award (All Students)
Unsung Champion Award (All Students)
Sustained Commitment Award (All Students)
Think. Care. Act. (All Students)
Add option
or
add "Other"
…
Answer key
(0 points)
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Please explain (in 500 words or less) why you are nominating this individual for this specific award.
Please explain (in 500 words or less) why you are nominating this individual for this specific award.
Question Type
Short answer
Paragraph
Multiple choice
Checkboxes
Dropdown
File upload
Linear scale
Multiple choice grid
Checkbox grid
Date
Time
Please note that this will be the only documentation that the selection committee will see to make their decisions, so please be as specific as possible with your response.
Answer key
(0 points)
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