DSC FALCON STUDENT ENGAGEMENT NOMINATION
2019-2020 ACADEMIC YEAR
TYPE or PRINT (Attach extra pages if necessary)
The Falcon Student Engagement award is presented to students who have been actively engaged
in representing DSC’s values of community, integrity, excellence, diversity, innovation and
student success. Active engagement includes any voluntary academic activities above and
beyond course requirements, involvement in student clubs and organizations, supporting
academic programs and services, assisting other students, and community service. Paid
activities such as work-study or required coursework are not considered for this award.
Name: Student ID #:
Physical Address:
City: State: Zip:
Telephone Number: Major:
Email Address:
Credit Hours Completed:
Daytona State Cumulative G.P.A.:
Educational and Career Objectives: (Be Specific)
Contributions to the community while enrolled at Daytona State:
Please estimate number of hours spent on each activity per week.
Contributions to the college while enrolled at Daytona State: Including student life, clubs, and sports.
Please estimate number of hours spent on each activity per week.
Please describe how the student’s actions reflect the college values of community, integrity, excellence,
diversity, innovation or student success.
Print Name of Nominating Faculty or Staff Member:
Signature of Nominating Faculty or Staff Member _________________________________________
Phone ext. __________________ Office Bldg. /room _______________ Date_____________________
Due to the Student Life Office, Bld. 130 Rm. 113 February 21, 2020