DR. PHYLLIS R. KLOTMAN PERSONAL SAFETY AWARDS

NOMINATION FORM : COMMISSION ON PERSONAL SAFETY


The Personal Safety Achievement Award recognizes the contribution of an individual toward improving the personal safety environment on our campus. The Leadership in Personal Safety Award recognizes a university unit or organization that has made a significant effort to improve personal safety on our campus.

Nominations are due Friday, April 4, 2008. Please make only one nomination for each award.

If you wish to submit a paper application, you can download a copy here and submit it to Memorial Hall East, Room 123 (ATTN: CPS Coordinator).

Personal Safety Achievement Award

Name of Nominee: Nominee's Department:
Nominee's Email: Nominee's Phone No.:
Nominee's Status: Nominee's Mailing Address:

Please explain why your nominee should receive this award.

Leadership in Personal Safety Award

Name of Unit/Organization: Contact Person:
Org/Contact Email: Org/Contact Phone No.:
Org/Contact Mailing Address:

Please explain why this organization should receive this award.

Your Name:

Your Email:

Today's Date:


Finished? Please check that all of your information is correct before submitting.
Once you are sure that your application is complete, click Submit!





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