PHSA Student of the Month Nomination Form
Please fill out this form if you would like to nominate a current MPH, MSc/MHSc or PhD student at the Dalla Lana School of Public Health for recognition by the Public Health Students' Association as Student of the Month.

Eligibility Criteria:

Nominees must be currently enrolled in DLSPH in a Master or Doctoral Program.
Nominees may only be awarded Student of the Month once in any given academic year.
Nominees must demonstrate at least one of the following criteria:
- Commitment to excellence in community engagement and development at the DLSPH
- Contributions to improving the DLSPH environment, learning culture, and society in general, and inspiring others to do the same.
- Commitment to positive culture at the DLSPH
- Passion for, and dedication towards a community health-related cause
- Demonstrates social responsibility and commitment to social justice
- Leadership, innovation and excellence in the application of knowledge to practice

Students, staff, and faculty can use this form to nominate a student.
Email address *
Nominee's First and Last Name *
Your answer
Nominee's Email *
Your answer
Nominator's First and Last Name *
Your answer
Nominator's Email *
Your answer
What is your relationship to the nominee? *
Your answer
Reason for nominating *
Your answer
Which of the following criteria does the student meet? *
Required
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