The Chair Academy: 2010 Conference

Recognize an Exemplary Leader Form

Form Submission is Closed!

Exemplary Leader's Information:

Name:
Title/Position:
College Name:
Address:
City, State, Zip:
Phone Number:
Email:

Please provide us with a brief summary in paragraph form illustrating several examples in which the leader or team of leaders exhibited academic and administrative excellence and thus why they should be recognized by the Chair Academy as an Exemplary Leader (no more than 75 words):

Nominator's Information:

Name:
Title/Position:
Phone Number:
Email:

Other Information

College President's Name:
Phone Number:
Email:

Individual or team name as it should appear on the award:

Will the nominator be present at the conference?
yes no

Will the exemplary leader(s) be present at the conference?
yes no

Please send a high quality; digital picture (shoulder shot) in .jpg format, minimum 5"x7", website photos will not be accepted,to info@chairacademy.com for inclusion in the Exemplary Leader booklet which will be distributed at the Conference, for inclusion in the summer Leadership journal, and for placement on the Chair Academy’s website.

Note: the exemplary leader(s), or their nominator, must be present at the conference to receive the award.

Submission is Closed