NCHC Faculty/Director Nomination Form

1. Select Honors Status

2. Select Award *This question is required.

3. Nominee Contact Information

First Name

Last Name

Institution

Street Address

Apt/Suite/Office

City

State

Zip

Email Address

Phone Number

4. Please list all NCHC, Regional and/or state honors organization leadership activities.

5. Please detail any scholarly activities related to honors education.

6. Please detail any NCHC, regional and/or state honors special events, institutes etc.

7. Please list any recognitions for outstanding teaching on the nominee's home campus.

8. Please detail any assistance provided to other honors programs/colleges, such as site visits, consulting etc.

Three Letters of Recommendation are required for this nomination. One letter must come from the nominee's home institution. Please upload these letters below.

9. Letter of Recommendation #1 *This question is required.Please upload here:

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10. Letter of Recommendation #2 *This question is required.Please upload here:

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11. Letter of Recommendation #3 *This question is required.Please upload here:

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12. Curriculum VitaePlease upload here:

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13. PhotoPlease upload here:

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