Herring Nomination Form Spring 2020 Nominee's Name* First Last In no more than 200 words, describe how the nominee has advanced the mission of the LGBTQ Center by raising awareness and seeking inclusion of sexual and gender minorities on Grounds? Please name and describe specific programs or initiatives to which this person has contributed demonstrating their leadership, citizenship, and/or fellowship.*In no more than 200 words, describe how you know the nominee. In what capacity have you worked with this individual and for how long?*Are there any additional comments you would like to share with us? (200 word limit)Your Contact Information (Nominator)Name* First Last Email* Phone*Your affiliation with the University* Undergraduate Graduate Student Faculty University Graduate Community Member Staff In evaluating nominees for the Herring Scholarship for Social Awareness, the selection committee would like the opportunity to evaluate the nominee's impact on their community. To help us achieve this, please provide the names of up to three (3) people who can attest to your nominee's qualifications for this award.Reference (Full Name) #1* Reference #1 Email* Reference (Full Name) #2 Reference #2 Email Reference (Full Name) #3 Reference #3 Email Thank you for your submission!With any questions, please feel free to reach Blakeley at: blake@serpentinesociety.org Δ
