2016 SLCE Award Nomination Form
Service-Learning and Civic Engagement Recognition Awards Nomination Form

The 9th annual Service-Learning and Civic Engagement Conference, Stronger Together, is an opportunity to recognize and honor faculty, staff, students and community partners for their contribution to service-learning and civic engagement in Maryland and Washington DC colleges and universities.

STRONGER TOGETHER: MAKING OPPORTUNITIES OUT OF CHALLENGES
Saturday, April 2, 2016 -- 10:00 a.m. - 4:00 p.m.
The Universities at Shady Grove -- 9636 Gudelsky Drive, Rockville, MD 20850

All awards recognize the outstanding impact of the nominee’s contribution to service-learning and civic engagement in higher education. Students, faculty, staff and community partners may submit nominations. Self-nominations are also accepted for all awards. Award recipients will be honored during the SLCE Conference on Saturday, April 2, 2016.

**Nomination Deadline Extended to Mon, Feb 8, 2016 Due to Weather Cancellations**
To Nominate: Submit a Nomination Form by Monday, February 8, 2016.
Nomination includes a 500-word recommendation detailing the nominee’s contribution.

For questions regarding the award, please contact us at slcenominations@gmail.com.
NOMINEE INFORMATION
Please indicate nomination for:
Nominee Name
Your answer
Mailing Address
(Street Address, City, State, Zip)
Your answer
Telephone Number
Your answer
Email Address
Your answer
College or University of Nominee
For community partner nominations, please include the College or University collaborator.
Your answer
Community Agency Name
For community partner nominations only.
Your answer
Department
For Faculty, Staff, and Student nominations only.
Your answer
Student Graduation Date
For undergraduate and graduate student nominations only.
Your answer
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