PAR Faculty Distinguished nomination form

Faculty Development Committee

Phyllis A. Roth Faculty Distinguished Service Award Nomination Form

The Phyllis A. Roth Faculty Distinguished Service Award honors special achievement in service and leadership.

The completion of this form serves as a nomination letter for this year's candidates for the Phyllis A. Roth Faculty Distinguished Service Award. To the best of your knowledge, please respond briefly to each of the following questions.

If you have questions or need assistance, please contact the Office of the Dean of the Faculty and Vice President for Academic Affairs at ext. 5705.

Your Information

Your Name:*

Your Email:*

Your Department:*

Nominee Information

Nominee's Name:*

Nominee's Department:*

What brings you to nominate this faculty colleague for this special recognition?

Reason for Nomination:

What source(s) of information support your nomination? Please cite evidence that demonstrates the nominee's excellence in service according to the guidelines set forth in the 91暗网 Faculty Handbook ("Evaluative Criteria for Continued Service".)

Sources of Information:

Please provide a clear picture of the nominee's record, indicating a continuing history of exceptional service to 91暗网 and its impact on the College. Please note that priority will be given to seniority in academic rank and length of service at 91暗网.

Nominee's Record:

Are there any other comments you would like to offer that are not captured by the preceding questions?

Comments:

By typing your name in the space provided, the Faculty Development Committee will accept this as a fully-signed document.

Your Signature:*

91暗网

Phyllis A. Roth Faculty Distinguished Service Award Nomination Form

Faculty Development Committee Contact

Contacts

MAIL