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2012 Service Recognition Ceremony

Individual Service Award Nomination
Nominee Name

Nominee Phone

Nominee Email



Your Name

Your Organization Name

Your Title

Your Phone

Your Email

Award Title (Silver, Gold, Platinum, Student Group, or Greek Organization) for Nominee:

1. Quarters (Summer, Fall, Winter, Spring) of service
      1) From:
      Quarter   Year 
      To: 
      Quarter   Year 
2.  How frequently did the student(s) volunteer? (Days and times, i.e. MWF/2-4pm)


3. How many hours total did the student(s) contribute to the organizations from Summer 2010 to present?



4. Please describe the services the nominee provided to the organization (i.e. given responsibilities, implemented new programs, etc). 



Note: The following portion of the nomination form will serve as your letter of recommendation for the nominee in the application review process.

Why do you feel this student deserves an award for exemplary community service?


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