MUSC Distinguished Faculty Service Award Nomination Form: 3/20

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MUSC Distinguished Faculty Service Award Nomination Form

I. Backgroung and rules
A. Purpose of award
This is an annual award to recognize and honor faculty members of MUSC who, during a substantial portion of their careers, have provided exceptional and sustained service and contributions in teaching, research, health care, and/or public service to the university and citizens of South Carolina.

B. Nomination procedures/rules
Nominations will be accepted from MUSC faculty, staff, and alumni by the MUSC provost and the Distinguished Service Award Committee. All nominations must be submitted on this form with appropriate attachment(s).

II. Nomination form
Complete the following information and submit no later than April 16 to Dr. John R. Raymond, Provost, 179 Ashley Avenue, Colcock Hall, MSC 002, MUSC, Charleston, SC, 29425 (or fax to 792-5110).
A. Nominee and faculty title (full name, type or print)
________________________________________________________________
_______________________________________________________________

B. Nominator, address, telephone, e-mail (type or print)
________________________________________________________________
_______________________________________________________________

C. Written justification: Attach a typed or printed narrative of no more than two single-spaced pages directly addressing the contributions made to MUSC and those the institution serves.

D. Other information: A copy of the nominee’s curriculum vitae or professional resumé should be enclosed. Additional letters of endorsement are encouraged in order to demonstrate the breadth of the nominee’s contributions.

Friday, March 20, 2009

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