Distinguished Service Award Nomination Form

Luther College Distinguished Service Nomination Form

Nomination, Selection, and Award Procedures

Any individual may make a nomination for the Luther College Distinguished Service Award. To be considered, nominations must be submitted using the form below or to the President’s Office in writing (email will suffice) and will clearly identify how the nominee meets some or all of the criteria listed above. Members of the selection committee can also make nominations.
Nominations can be submitted at any time and will be kept on file in confidence for a period of five years. Nominations need not be resubmitted during this timeframe.
The award need not be presented annually, but will be done so at the discretion of the committee when a truly worthy candidate is nominated.
The selection committee will be appointed by the President and will normally consist of at least one staff member from each campus, two Board members, and one or two other members of the Luther College community whether that be alumni, former staff, parents, past recipients, etc. The President will try to have committee members serve more than a year at a time to give some continuity to the committee’s deliberations.
Given the two-campus nature of Luther College, the selection committee will normally pick two recipients, one for the High School and one for the University campus.

The award will be presented by the President, the Chair of the Board of Regents or their designate at a suitable occasion at the discretion of the selection committee (for example, Founders’ Day, a long-service ceremony, a Convocation ceremony, a Board of Regents event, or an event specific to the award). If the nominee is not able to attend the event, the award will be presented in absentia.

Luther College Distinguished Service Award Nomination Form

NOMINATOR INFORMATION
1) Your Name (First & Last Name)

2) Your Contact Information
Phone Number (required):

Email:

NOMINEE INFORMATION
3) Name of Nominee (First & Last Name)

4) Mailing Address of Nominee, if known.
Street/Box Number:

City/Town/State:

Postal Code/Zip Code:

Country:

5) Phone Number, if known:

6) Email, if known:

Brief summary indicating why this nominee fits the criteria of the Distinguished Service Award (please limit to 250 words):

Any other information that might support the nomination including letters of support, newspaper clippings, book titles, articles, etc. (please list below):

Please review the above nomination form to ensure all questions have been answered. After you click on the "Submit Nomination" button below, a message should appear on the screen confirming your nomination has been received. Please note that this may take a few seconds. If the message does not appear after a minute, please contact 1.306.585.5144.

Personal information on this form is collected pursuant to the Personal Information Protection and Electronic Documents Act (“PIPEDA”) and The Local Authority Freedom of Information and Protection of Privacy Act ("LAFOIP"). Luther College at the University of Regina will use your information for all administrative and academic matters and your information may be shared with the University of Regina.Your information will remain confidential, and will only be used or disclosed as authorized under PIPEDA/LAFOIP.

Should you have any questions about the collection of information, please contact Luther College High School at lchshr@luthercollege.edu.