Leadership and Service Award

Please complete the following form to apply or nominate a candidate for a Leadership and Service Award.

    

Nominator Information
 
First Name    Middle Name    Last Name    Suffix
     
Phone   E-mail
 

Who Would You Like To Nominate?
 
 
Nominee's Name
 
Your Relationship to Nominee?
 
Your Relationship to McKendree University?
 
Nominee's Email
Nominee's Phone Number
 
Question 1
 
 
Response
 
Question 2
 
 
Response
 
Question 3
 
 
Response