Application Form

WOMEN’S STUDIES PROGRAM COORDINATORS’ AWARD
2000

Nominee: _________________________________________________________________

Campus/Local Address: ______________________________________________________

Campus/Local Phone: _______________________________________________________

Nominator: ________________________________________________________________

Campus/Local Address: ______________________________________________________

Campus/Local Phone: _______________________________________________________

Please provide a summary of the nominee’s course work and/or service activities in Women’s Studies and a statement indicating the significance of the nominee’s contribution to the Women’s Studies Program (use another sheet if necessary):

Signature: _________________________________________________________________

Date: ____________________________________________________________________

DEADLINE: Completed applications are due to the Women’s Studies Program Office (Dreiser Hall 201) by Friday, January 28, 2000.