Nomination Form

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Plemmons Leadership Medallion Nomination

Nominee Information

First name

Middle name

Last name

ASU Email

Department/Major

Years at Appalachian

References

Contact information for 2 reference(s) must be included for this application. These references will be sent a link to submit letters of recommendation which should include relevant information that gives examples of the nominees leadership ability, dependability, integrity, self-confidence, maturity, and communication sklls that reflect the nominee's ability to enrich the quality of student life and learning outside of the classroom.

Reference 1

First Name

Last Name

Department

Phone Number

Email Address

Relationship to Nominee

Reference 2

First Name

Last Name

Department

Phone Number

Email Address

Relationship to Nominee

Statement

Please upload a statement which supports this nomination for Plemmons Leadership Medallion. This statement should address the following aspects for the person you are nominating:

Work and involvement with students outside the classroom
Role or roles that have had an impact on the life of students on campus
Meritorious involvement- why does this person stand above others?

Nominator Information

Nominator's first name:

Nominator's last name:

ASU E-Mail

Relation to Nominee:

In the event the nominee is unsuccessful in the Plemmons process, you can use the below application to "opt in" to other award nomination processes. Each award is housed in the Division of Student Affairs. Your nominee must meet the minimum award qualifications (e.g., a student employee for the Dunnigan award, a current Graduate Student for the Blimling award, etc.). Please select all awards for which you wish the nominee to be considered. Be sure to click the "Details" link for award requirements before "opting in."

Ronny L. Brooks Award Details

Bobby L. Dunnigan Service Award Details

Gregory S. Blimling Award for Outstanding Graduate Student in Student Affairs Details

Plemmons Medallion