2018 Horace Moody Award Nomination Form HORACE MOODY AWARD NOMINEE INFORMATION Highlighted sections are required fields. Name Phone Institution Fax Address Email 1 City State/ Province Zip code Email 2 NIRSA region (select one): I Years as a NIRSA member Nominees for the award should demonstrate performance in one or more of the following areas: Attending and engaging with students at Student Lead Ons or Emerging Recreational Sports Leadership Conference. Serving on the Student Leadership and Academic Awards Committee, Student Professional Development Committee, or the Career Opportunities Center Committee. Serving as a mentor in the NIRSA mentor/mentee program. Participating in the Take a Student to Lunch session at the Annual Conference. Serving as a mentor to staff through engagement in NIRSA, other recreational opportunities, and/or professional development. Presenting in Student Professional Workshops. Please summarize why you feel this person is deserving of this student development award. Please provide an example of when the professional exemplified one or more of the qualifications. (500 words maximum) NOMINATOR INFORMATION Highlighted sections are required fields. Name Phone Institution Fax Address Email 1 City State/ Province Zip code Email 2 SUBMITTING THIS FORM 1
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2018 Horace Moody Award Nomination Form
HORACE MOODY AWARD NOMINEE INFORMATIONHighlighted sections are required fields.
Name Phone Institution Fax Address Email 1
City
State/Province Zip code Email 2
NIRSA region (select one): I Years as a NIRSA member Nominees for the award should demonstrate performance in one or more of the following areas:
Attending and engaging with students at Student Lead Ons or Emerging Recreational Sports Leadership Conference.
Serving on the Student Leadership and Academic Awards Committee, Student Professional Development Committee, or the Career Opportunities Center Committee.
Serving as a mentor in the NIRSA mentor/mentee program. Participating in the Take a Student to Lunch session at the Annual
Conference. Serving as a mentor to staff through engagement in NIRSA, other
recreational opportunities, and/or professional development. Presenting in Student Professional Workshops.
Please summarize why you feel this person is deserving of this student development award. Please provide an example of when the professional exemplified one or more of the qualifications. (500 words maximum)
NOMINATOR INFORMATIONHighlighted sections are required fields.
Name Phone Institution Fax Address Email 1
City
State/Province Zip code Email 2
SUBMITTING THIS FORM
Once you have completed this form in full, please save as a PDF preferred (or as a Word doc). Then attach it to an email and send to the NIRSA Membership Outreach Coordinator, Emily Hughes. A member of the Horace Moody Award Committee will contact you at a later date about your nomination materials.
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2018 Horace Moody Award Nomination Form
To facilitate more efficient processing of your nomination materials, please use a subject line “Horace Moody Award nomination for John Doe”
If you have any difficulties completing this form, please contact the NIRSA Membership Outreach Coordinator, Emily Hughes.
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