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Cover Sheet
NOMINATION FOR ACADEMIC RECOGNITION AWARD
1. Award Name (Category)
__________ Trustees' Achievement Award
__________ Lindback Distinguished Teaching Award
__________ Emeritus/Emerita Designation
___________Distinguished Sponsored Research Award
___________E. Riley Holman Memorial Faculty Award
___________Deans’ Award for Teaching Excellence in General Education
___________ Campus Diversity Award
2. Nominator
Name: __________________________
Department*: ____________________
*if appropriate
Affiliation if outside WCU:_____________________________________
Signature of Nominator ________________________ Date: _________
3. Nominee
Name: _________________________
Department: __________________________
Years in current rank: ___________________
Date of beginning service at the University______________
Dates of part-time service, if any:______________________
Signature of Nominee:________________________ Date: __________
Revised 9/16
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