Diamond Honoree Nomination Form

Diamond Honoree Nominee Information
Name
Institution/Employer
Mailing Address
Phone
Email
Approximate years in higher education
Education
Administrative Experience
Teaching Experience
Other Experience/Service
Awards/Honors
Additional information you wish to share
Nominator's Information
Name
Institution/Employer
Mailing Address
Phone
Email
Relationship to nominee

The Diamond Honoree Program is a fund raising initiative of the ACPA Foundation. Those selected for recognition must be willing to have money raised in their name. A minimum amount of $1,500 must be raised through a campaign coordinated by the Nominator or some other individual(s) identified by the Nominator. Please indicate below by checking the diamond next to each "YES" statement that you agree to serve as the Campaign Advocate for this Honoree, or that you will identify another individual to serve in this capacity, and that you understand that the Campaign Advocate will be responsible for raising a minimum of $1,500 on behalf of the ACPA Foundation.

YES, I AGREE TO SERVE AS THE CAMPAIGN ADVOCATE FOR THIS NOMINEE OR TO IDENTIFY SOMEONE ELSE TO SERVE AS THE NOMINEE’S ADVOCATE.
Advocate Agreement
YES, I UNDERSTAND THAT THE CAMPAIGN ADVOCATE WILL BE RESPONSIBLE FOR RAISING A MINIMUM OF $1,500 IN THE NAME OF THIS HONOREE.
Fundraising Agreement
Should be Empty:

Diamond Honoree Nominee Information

Nominator's Information