Undergraduate Teaching Awards Nomination Form

Use this form for Atherton, Eisenhower and Teaching Fellow Award nominations.

*Required

Nominee Information

*Last Name (family name):

*First Name (given name):

*Teaching Area: (e.g. academic field/specialty, department, program, course)

College:

*Campus:

*Email:

Office location/building:

Nominator Information

*Last Name (family name):

*First Name (given name):

*Email:

*Permanent Mailing Address:

Telephone number:

*How do you know the person you are nominating? (e.g. current student, former student, colleague, administrator)

*Briefly, why you are nominating this person?