Nomination form - Georgian College · Web viewIf you exceed word count, your nomination may be disqualified. Bullet points are acceptable. Bullet points are acceptable. The Recognition

Board of Governors’ Award of Distinction – Honorary Diploma Please complete this form and email it to [email protected], along with the scanned signature page. The deadline each year is the second Friday in February. Inquiries regarding the awards may be directed to the Office of the Board of Governors at 705.728.1968, ext. 1252.

Purpose: To honour external candidates who have made a major contribution to an academic program at Georgian.

The award consists of a framed diploma and a citation, and will be presented at an appropriate convocation or board event. Under exceptional circumstances, the award will be presented posthumously or in absentia. If there are no eligible candidates in a given year, the award will not be granted.

Eligibility Nominees will:

have demonstrated excellence in their profession/industry be highly regarded by their peers/colleagues have made a major contribution to an academic program at Georgian through a significant

contribution of expertise, influence and personal time

Submission guidelines: Please include key information that will enable the Recognition Committee to distinguish your nomination from others. Do not alter this form in any way.

This nomination package must be supported by three individuals: 1) The lead nominator 2) An individual from within and/or outside the same academic area/department 3) An individual from another academic area/department

Nomination form

Name of nominee: include current employer, role and department, if applicable

Contact information: include email and phone number

Name and area/department of lead nominator:

Names and areas/departments of 2 co-nominators:

Quote or testimonial on why you’re nominating this person: 3 to 4 lines

1

Please provide a brief description (max. 150 words) of the nominee’s contributions in each of the following areas. If you exceed word count, your nomination may be disqualified. Bullet points are acceptable.

The Recognition Committee will evaluate each section out of 5 – fully met (5), partially met (3) or unmet (1). They will use these scores to help rank submissions in this award category.

Demonstrated excellence in their profession/industry

/5

Highly regarded by their peers/colleagues

/5

2

Demonstrated commitment to the values of the college

/5

Made a major contribution to an academic program at Georgian through a significant contribution of expertise, influence and personal time

/5

TOTAL /20

Additional background information to support the nomination, if relevant

3

FREEDOM OF INFORMATION AND PROTECTION OF PRIVACY ACT

NOTIFICATION REGARDING THE COLLECTION OF PERSONAL INFORMATIONThe personal information in this form is being collected under the authority of the Ontario Colleges of Applied Arts and Technology Act, 2002, and is compliant with the Freedom of Information and Protection of Privacy Act, 1990. The personal information is being collected for the purpose of administering and advertising this award. Information that you are providing about yourself, co-nominators and the nominee may be disclosed to the nominee, regardless of whether or not the nominee is selected for the award competition process.

4