2013 HONORS CONVOCATION
STUDENT HONOREE FORM
IMPORTANT INSTRUCTIONS – PLEASE COMPLETE UPON RECEIPT – Submission deadline is Friday, February 15, 2013.
The information provided will be used for the 2013 Convocation Program. Type ALL information requested on the fields below. Please use the TAB key to move from one field to another. Fields will expand as space is needed. After you and the college Dean sign the Honoree Form, please submit (as an attachment) to the Office of University Relations at . If you have any questions, please contact the Office of University Relations at 747-8244 or at .
NOMINATING DEPARTMENT:
(Note: Form must be completed electronically. Shaded fields will expand accordingly to fit your response.)
1. OUTSTANDING GRADUATE STUDENT AND OUTSTANDING SENIOR BY MAJOR
A. One academically outstanding graduate student who graduated in Summer 2012, Dec. 2012, or will graduate May 2013 – only one student per major. (Please use additional forms as needed)
Student’s Name: Last: First: Middle: Major: GPA:
Address: City: State: Zip: UTEP E-mail: Alternate E-mail:
If applicable:
Student’s Name: Last: First: Middle: Major: GPA:
Address: City: State: Zip: UTEP E-mail: Alternate E-mail:
If applicable:
Student’s Name: Last: First: Middle: Major: GPA:
Address: City: State: Zip: UTEP E-mail: Alternate E-mail:
B. One academically outstanding senior by major who graduated in Summer 2012, Dec. 2012, or will graduate May 2013 – only one student per major. (Please use additional forms as needed)
Student’s Name: Last: First: Middle: Major: GPA:
Address: City: State: Zip: UTEP E-mail: Alternate E-mail:
If applicable:
Student’s Name: Last: First: Middle: Major: GPA:
Address: City: State: Zip: UTEP E-mail: Alternate E-mail:
If applicable:
Student’s Name: Last: First: Middle: Major: GPA:
Address: City: State: Zip: UTEP E-mail: Alternate E-mail:
2. DEPARTMENT AWARDS
Department award named in honor of someone – do not include scholarships – recipient does not necessarily have to be graduating in the 2013 academic year.
Award Title:
Recipient’s Name: Last: First: Middle: Major: GPA:
Address: City: State: Zip: UTEP E-mail: Alternate E-mail:
3. OUTSTANDING GRADUATE AND UNDERGRADUATE THESIS (BY DEPARTMENT)
A. One outstanding graduate thesis by department from a student who graduated in Summer 2012, Dec. 2012, or will graduate May 2013– only one thesis nomination per department.
Student’s Name: Last: First: Middle: Major: GPA:
Address: City: State: Zip: UTEP E-mail: Alternate E-mail:
B. One outstanding undergraduate thesis by department from a student who graduated in Summer 2012, Dec. 2012, or will graduate May 2013– only one thesis nomination per department.
Student’s Name: Last: First: Middle: Major: GPA:
Address: City: State: Zip: UTEP E-mail: Alternate E-mail:
4. OTHER STUDENT AWARDS
Other Student Award - The award is based entirely on academic achievement and is administered through the department or Graduate School.
Award Title:
Recipient’s Name: Last: First: Middle: Major: GPA:
Address: City: State: Zip: UTEP E-mail: Alternate E-mail:
5. DEPARTMENTAL HONOR SOCIETIES
Only Department HONOR Societies that are currently active and registered with UTEP Student Engagement and Leadership Center (formerly known as Student Development Center) for the Spring 2013 Semester will be included in the Honors Convocation program. Find the status of the organization via Mine Tracker. Please attach to this form a printed copy of the organization profile found on the registered student organizations’ website (http://sa.utep.edu/rso/). A printed copy of the organization profile MUST be submitted for its consideration and inclusion in the program. Direct your registration and current status questions to Student Engagement and Leadership Center at 747-5670.
Honor Society Complete Name:
President’s Name: Last: First: Middle: GPA:
Address: City: State: Zip: UTEP E-mail: Alternate E-mail:
Advisor’s Name: Department: Ext: UTEP E-mail:
If applicable:
Honor Society Complete Name:
President’s Name: Last: First: Middle: GPA:
Address: City: State: Zip: UTEP E-mail: Alternate E-mail:
Advisor’s Name: Department: Ext: UTEP E-mail:
6. SIGNATURES
The information will not be accepted without the Dean’s signature (electronic signatures are accepted).
Signature: Date:
Department/Program Head
Signature: Date:
Academic Dean
7. COMMENTS
.
Return by Friday, February 15, 2013
This form can also be found online at www.utep.edu/universityrelations follow the link to University Events, 2013 Honors Convocation and you will find this form as part of the listed links.