Fillable Harden Nomination Form (Montgomery College)

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Harden Nomination Form (Montgomery College)

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Dr. Harry Harden, Jr. Student Academic Excellence Medallion Award Nomination
Form
Academic Year
2019
Faculty, staff and administrators are invited to nominate Montgomery College students who have shown excellence inside
and outside of the classroom for the Dr. Harry Harden, Jr. Student Academic Excellence Medallion Award. One student from
each of the Col l ege’s three ca mpus es wil l be chosen for this prestigious award based on the following criteria.
Students must have:
· earned a cumulative 3.5 or higher grade point average;
· demonstrated outstanding leadership on campus or in our external community;
· excelled in service to the College or our external community; and
· been approved for graduation for May 2019 with an associate’s degree.
Nominations must be received by the Office of the Vice President/Provost of the respective campus by the close of
business, Friday, April 12, 2019. Please send the attached nomination form by campus mail or email. Selections will be
made not later than Friday, April 26, 2019, and submitted to the Office of the SVP for Students Affairs. If you need more
information, please contact the student’s campus VP/Provost office.
STUDENT INFORMATION: (Please type or print the information requested.)
Student Name M# (MC Identification Number)
Campus Major
Cumulative GPA (please attach official transcript) Number of Credits Completed
ADDITIONAL INFORMATION:
1. Has the student completed all requirements for degree and applied for graduation?
Yes
No (If no, student is ineligible for this award.)
2. What degree will the student receive?
3. I have provided a copy of the student’s Montgomery College transcript.
Yes No (I
f no, please supply a copy with this nomination.)
4. Please explain why you have chosen to nominate this student for the Dr. Harry Harden Jr. Academic Excellence Student
Medallion Award. In your statement(s), describe the student’s academic achievement, outstanding leadership skills, and
excellent service to the College or the community. Also, make sure to submit any supplemental materials to demonstrate
student leadership and service involvement (e.g., letter or certificate of participation, copy of relevant information from
student portfolio).
Supplemental page
(Remember to sign and date the last page)
Name of Nominator (please print)
Signature of Nominator Date
Please submit this nomination form and supporting materials to:
The Respective Campus’ Office of the Vice President/Provost
Attention: DHHJ Academic Excellence Student Medallion Award Nomination
Forms may be submitted by mail or electronically. Contact your VP/P office for email and contact information.
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Harden Nomination Form (Montgomery College)

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Completed 19 July 2020

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