MICHAEL COOKE STUDENT LEADERSHIP AWARDS

Nomination Form

All nominations must include a nomination statement and completed nomination form.

1. NOMINATION STATEMENT

Please attach a statement, no longer than 2 pages, outlining why the candidate embodies the criteria of the awards as follows:

•Demonstrates leadership and initiative in student or college affairs including committees, organizations, or groups.

•Volunteers to improve the quality of life of students.

•Contributes to the sense of community at George Brown College.

•Dedicates time to volunteering in the wider community as a complement to their contributions to the college.

Please be as detailed as possible when describing the student’s achievements. Additional material that helps to support the nomination will be accepted and can be attached to the nomination.

*Nominators – Please consider the following when writing your nomination letter. All nominations will be judged on the following criteria.

CRITERIA:

Demonstrates leadership and initiative in student or college affairs including committees, organizations, or groups. (Out of 25)

Volunteers on campus to improve the quality of life of students. (Out of 25)

Contributes to the sense of community at George Brown College. (Out of 25)

Dedicates time to volunteering in the wider community as a complement to their contributions to the college. (Out of 25)

Total Score out of 100.

2. NOMINATION FORM

Nominee Information:

Title: Mr. □ Ms. □ Miss □ Mrs. □ Other □ ______

Full name of student(as it will appear on the certificate):

______

Phonetic pronunciation of nominee name(as it sounds):

______

Student number:______Student email:______

Student’s program:______

Mobile Phone:______

Nominator Information:

Name of Nominator: ______

Position/Title: ______

Are you a: □ Faculty Member □ Staff Member □ Alumni □ Student

Email:______

Phone:______

Student Consent:

I consent to this nomination.

□ Yes

Is the information on the nomination form correct?

□ Yes

I am expecting to graduate from George Brown College in 2018.

□ Yes

□ No

If no, please explain: ______

I consent for the selection committee to receive a copy of my transcript or academic record.

□ Yes

I consent for the Michael Cooke awards committee, George Brown College and George Brown College Foundation to use my name, photograph and nomination information publicly, including but not limited to event programs, marketing materials and other collateral.

□ Yes

Signature of student: ______Date:______

NOMINATION CHECKLIST:

Completed Nomination Form (mandatory)

Statement outlining why the candidate should be considered (mandatory)

Any other documents supporting the statement (optional)

Please submit all nominations via email to by April 20, 2018. Winners will be notified by April 27, 2018. If you have any questions about the nomination process, please contact Norman Javier at 416-415-5000x5529 or .