UWG SCFM Distinguished Service Award Nomination Form - 2023
Deadline: December 5

The School of Communication, Film, and Media at the University of West Georgia invites you to nominate an individual for the Distinguished Service Award.  Please observe the eligibility requirements and complete the information on your nominee.  The candidate will be made aware of the nomination only if they are selected for the award.
 
Note:  To be considered for the award, nomination forms must be completed in full.

Requirements:
 
Ø Has consistent and significant service to the SCFM; particularly in regard to strategic imperatives
Ø Has notable achievement(s) in career field or public service
Ø May be awarded to an individual or unit/organization
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Nominee Information
Individual or Organization/Entity *
Name of Individual/Organization *
Contact Name for Organization (skip if individual)
Email *
Phone
Mailing Address
Employer
Title/Occupation
Education (Additional Undergraduate, Graduate, Other)
Nominator Information
First Name *
Last Name *
Email *
Phone *
Please tell us why your nominee should be selected for the SCFM Distinguished Service Award by completing the following information below.
Describe the nominee's primary professional and/or volunteer contributions to the SCFM that qualify the nominee for this recognition. *
List any civic, social or professional organizations in which the nominee currently belongs or has belonged in the recent past. Please note any leadership positions and membership status. *
Tell us about any award(s) and/or special recognition(s) received by nominee. *
In what way(s) is the nominee a positive role model for today's SCFM students? *
Nomination forms must be submitted by the deadline (December 5) to be considered for the award.  All nominees and nomination information will be kept confidential.  An SCFM representative will contact the selected winner and their nominator after the final selection has been made by our Awards Selection Committee and faculty/staff vote.  Award winners will be recognized at Media Day.
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