Attach additional sheet(s) if necessary ~

Nominee:	Position: 	 School/institution:
Contributions and years of service:

The IACAC Service Award

Nomination Form

The IACAC Service Award is given to a member who has distinguished him or herself by exemplary service to the Affiliate. IACAC Service Award winners must have a minimum of 10 years of significant membership experience as a committee member, a committee chairperson, or an officer in IACAC or NACAC. Award winners must be nominated by peers. Members of the IACAC Nominating Committee, chaired by IACAC Past-President, Brandy Candler, will determine the award winner after reviewing all nominations.

IACAC/NACAC committees, committee chairs or offices: 	

Comments, reasons for nominating, quotes about nominee:	

Nominated by:	Position:

Nominator e-mail address: Nominator telephone number:
Nominator school/institution:	Date: 		

Return nomination form and any additional sheet(s) no later than February 1, 2018 to:

Brandy Candler
Ivy Tech
Email: bcandler@ivytech.edu
Phone: 812-298-2286