2017 Nomination Form for the CEW Carol Hollenshead Award for Excellence in Promoting Equity & Social Change
I am nominating the following University of Michigan faculty or staff member (may be an individual or group) to be considered for the Carol Hollenshead Award for Excellence in Promoting Equity & Social Change.

Nominations are due to CEW by 11:59 pm on December 15, 2016.

Please contact Janice Reuben, CEW Senior Associate for Programs and Outreach (734-764-6005 or via email reubenjs@umich.edu) for information about the 2017 nomination process.

Nominee's Name:
Your answer
Nominee’s position:
Your answer
Nominee’s department:
Your answer
Nominee’s email address:
Your answer
Nominee’s phone number:
Your answer
Description of Nominee's Accomplishments
Please describe how this person fulfills the following four criteria for the Hollenshead award: (Please note each criteria box is limited to 900 characters.)
Q1. Sustained effort and demonstrated outcomes in achieving greater equity in the U-M community or beyond:
Your answer
Q2. Creativity in devising strategic approaches to advocacy and problem solving:
Your answer
Q3. Demonstrated commitment to diversity and inclusion:
Your answer
Q4. Effective coalition building:
Your answer
Nominator's Information
Nominator’s name:
Your answer
Nominator’s position:
Your answer
Nominator’s department:
Your answer
Nominator’s email address:
Your answer
Nominator’s phone number:
Your answer
References We Can Contact About the Nominee
Please provide contact information for two people familiar with the nominee's accomplishments. The person making
the nomination CANNOT be one of the two references.
Reference #1 - Name
Your answer
Reference #1 - Phone Number
Your answer
Reference #1 - Email address
Your answer
Reference #2 - Name
Your answer
Reference #2 - Phone Number
Your answer
Reference #2 - Email address
Your answer
Questions about the Carol Hollenshead Award may be directed to Janice Reuben at reubenjs@umich.edu or 734-764-6005.
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