STUDENT NOMINATION FORM

Award Name:

Nominee Information

Name:
Degree or Program:
Anticipated Graduation Date:
Cumulative GPA:
Professional Occupation (if any):
Email Address:

Nominator Information

Name:
Relationship to Nominee:
Email Address:

Sections 1-3 must be completed by the nominee. Section 4 must be completed

by the nominator.
(1) Professional, Research, and Creative Achievements

Describe any research, creative, and/or extracurricular activities in which you are/were involved
as a student at UNO. Make sure to describe the outcomes of the project(s) and your contributions.
If you have any exceptional professional achievements and/or accomplishments in your field,
please describe them as well.
(2) Community and Service Achievements

What service(s) and contribution(s) have you made to advance the community (on a local, regional,
national, and/or international level) through civic, charitable, business, professional, or other
means?
(3) Leadership Achievements

How have you exhibited outstanding leadership in your career, community, and/or personal life?
(4) Nominator Support [For Nominators Only]

Why does your nominee deserve to be awarded? What attributes has your nominee demonstrated
to support this nomination? Provide any information about the nominee that you feel pertinent to
this award or that you would like to include in your submission.