UIAA at Chicago: Awards: Student Leadership Award Nomination Form

Student Leadership Award

The deadline for the 2008 nominations for this award has passed.

ALL INFORMATION MUST BE COMPLETED. Please use a separate form for each student nominee. If you have questions, please contact us at uiaaleadershipawards@uicalumni.org.

Nominee information

I would also like to like to nominate this student for the Activities Honorary Society.

Name of Student

Address (local or campus)

City

State

Zip code

Phone number

E-mail

College

GPA (Required)

Student ID number (Required)

Graduation date (Required)
(Nominees will have graduated in summer (August 2007), fall (December 2007) or are candidates for graduation in spring (2008)

If you are nominating more than one student, please rank this nominee here:
Rank of

Leadership Activities
(May include student organizations, volunteer services or campus departments)

Name of Activity (no acronyms)	Position held	Dates	Reference name/phone

Paid Postion (Yes/No) Yes No	Brief Description of Activity

Name of Activity (no acronyms)	Position held	Dates	Reference name/phone

Paid Postion (Yes/No) Yes No	Brief Description of Activity

Name of Activity (no acronyms)	Position held	Dates	Reference name/phone

Paid Postion (Yes/No) Yes No	Brief Description of Activity

Name of Activity (no acronyms)	Position held	Dates	Reference name/phone

Paid Postion (Yes/No) Yes No	Brief Description of Activity

Nominee Endorsement

Please describe in great detail the leadership development of this student and how his/her experiences has made a positive impact on the UIC community.

Nominator Information

Name

Title/Position

Address

City

State

Zip code

Phone number

Nominators and their recipients will be notified Jan. 31, 2008