Nomination Form

Nomination Form

The Civic and Community Engagement and Research Project (CCERP) is soliciting nominations for annual awards to be made at its Community Partners Recognition Breakfast on Friday, May 3, 2019.  These awards publicly recognize notable campus leaders, individuals and entities whose civic/community contributions have had a positive local impact. All Nominations are due by April 12, 2019. Nominations will be accepted for the following categories:

CCERP Nomination Form

CCERP Nomination Form

  • The categories are/Check One: *
    The categories are/Check One:
  • We respectfully request that you make a nomination or nominations by providing the information requested below.

    The award recipients will be selected based on the following criteria:

    1. Nominee falls into an eligible category.
    2. Nominee has made a significant contribution(s) to the campus, community or region.
    3. Nominee’s leadership or actions have benefited others or the community.
    4. Nominee’s leadership inspires or empowers others to become civically involved or engaged.

    If chosen, nominees will be contacted and may be asked to provide additional information

  • Address Address *
  • Mobile Phone: Mobile Phone: * - -
  • Nominee/Organization

    (Please list as much information as you are able)

  • Address Address
  • Mobile Phone: Mobile Phone: - -
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