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Supervisor Information Sheet
Please fill out the following form in order to be considered for a Citizen Leader Award.
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Last Name
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Your answer
First Name
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Your answer
Campus Address
*
Your answer
Position at Longwood University
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Your answer
Years at Longwood University
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Your answer
Email
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Your answer
Phone Number
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Your answer
Using the space below provide a statement describing your community service to Longwood and your community:
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Your answer
List any awards, scholarships, or special recognitions, which you have received. (Examples include previous Citizen Leader Awards, National Association Awards, Research Awards, Community Recognition Awards, etc.)
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Your answer
Explain briefly why you think working with student employees is important, what benefits (skills, etc.) you received from this experience, how this experience has influenced you. (100 words or less)
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Your answer
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