Community Engagement Award
Nomination Form for
Please include all information.
Nominee’s E-mail address _______________________________________________
Nominee’s phone number________________________________________________
Status: ____Full Time ______Part Time
Nominator’s Name ___________________________________________
Nominator’s phone number_______________________________________________
E-mail address _______________________________________________
Please address all areas listed in the criteria for your classification (i.e. Faculty, Staff, Student).
Limit your nomination letter to 5 pages.
Criteria on how the award is evaluated can be found at http://louisville.edu/communityengagement/outstanding-
Please supply all materials electronically to email@example.com .
All activity must have been performed during the 2011-2012 academic year (including Fall/Spring/Summer)
Submit application & materials electronically to firstname.lastname@example.org
Hard copies of optional documentation may be sent to the Office of Community Engagement, 209 Grawemeyer
Hall, ATTN: Outstanding Community Engagement Award
Nomination letter should not exceed 5 pages
Deadline for submission is April 27, 2012
Previous award recipients are not eligible to apply for this award cycle, however previous nominations are
encouraged to resubmit.
Self-nominations are not accepted. Community Partners must be nominated by a University student, faculty,
staff or alumnus.
There is no requirement for the award to be given in every category each year.