Faculty, Staff, and/or Student OUTstanding Service Award
We seek nominations of individuals within the Dickinson College community who identify as queer (LGBTQQIA) and have been actively involved in social justice work to create a more inclusive Dickinson community. Please complete the nomination form below. Self-nominations are accepted.

I wish to nominate:

Name of Nominee:
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Nominee Status
Nominee Address:
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Nominee Phone: (Including Area Code)
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Nominee E-Mail Address:
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Brief Summary of Nominee's Contributions:
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Nominated By:
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Nominator Address:
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Nominator Phone Number:
(Including Area Code)
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Nominator E-mail Address:
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