WesternU Academic Senate Award Nomination Form

* Required

Nominee Information:

Faculty Member Name: *

Department/College: *

For which award are you nominating? *

Harriet K. and Philip Pumerantz Award for Leadership and Service

Based upon the requirements for the Western University Distinguished Teacher of the Year Award, nomination materials should at minimum include:

• Cover page (name of nominee, title, email, phone, nominator's name and signature)
• Letter of nomination detailing the reason for the nomination, and the impact of the faculty member's leadership and service
• A list and length of service for university committees the faculty member is serving on (indicate whether member or Chair), as well as list and description of service to the local communities
• A curriculum vitae limited to ten pages with recent achievements highlighted
• A letter (limited to two-three pages) of recommendation from the nominator (dean, or department/unit supervisor)
• Other related evidence or documentation

Provost's Distinguished Scholar of The Year Award

Based upon the requirements for the Western University Distinguished Teacher of the Year Award, nomination materials should at minimum include:

• Cover page (name of nominee, title, email, phone, nominator's name and signature)
• Letter of nomination detailing the reason for the nomination
• A description of the faculty member's research and other scholarly accomplishments in the previous three academic years (e.g., extramural grant/contract funding; peer-and non-peer reviewed publications and book chapters; intramural grant funding; published abstracts; invited presentations; grant submissions; leadership in scientific societies)
• A curriculum vitae limited to ten pages with achievements in the last three academic years highlighted
• A letter (limited to two-three pages) of recommendation from the nominator (dean, or department/unit supervisor)
• Other related evidence or documentation

Western University Distinguished Teacher of the Year Award

Based upon the requirements for the Western University Distinguished Teacher of the Year Award, nomination materials should at minimum include:

• Cover page (name of nominee, title, email, phone, nominator's name and signature)
• Letter of nomination detailing the reason for the nomination
• A copy of the nominee's personal statement of teaching philosophy
• A description of the faculty member's teaching related accomplishments for which they are being considered as evidenced by peer and/or student teaching scores/evaluations, scholarship of teaching, design of new and innovative teaching methods or modalities, description of new courses, etc.
• A curriculum vitae limited to ten pages with recent achievements highlighted
• A letter (limited to two-three pages) of recommendation from the nominator (dean, or department/unit supervisor)
• Other related evidence or documentation

Describe the achievements that you believe qualify this individual for the award. Nominations must be a minimum of 500 words in length; there is no maximum. Be sure to relate your comments to the award criteria. The most persuasive nomination letters are those that cite specific examples to support general statements. (Note: You can prepare your narrative in advance and cut/paste it here.*

Submitted By:

Name: *

Phone: *

Email: *

Status: *
Dean
Department Chair
Faculty
Other:

Supporting Documentation:

Please upload your supporting documentation below:
IMPORTANT NOTICE: This form has a 2MB limit on file uploads. If your file is larger than 2MB please email it directly to Alyssa Rodriguez at: arodriguez@westernu.edu.

Please check your information and submit your form: