Review Panel Nomination Form
Please complete for each proposed off campus nominee
Academic Program Being Reviewed: _______________________________________________
Name of Nominee: ______________________________________________________________
Campus: ______________________________________________________________________
Title or Rank: __________________________________________________________________
Current Position: _______________________________________________________________
Address: ______________________________________________________________________
City: ____________________________________ State: ________ Zip: ___________________
Send completed Undergraduate form to: dennisn@csufresno.edu and lneal@csufresno.edu
Send completed Graduate form to: sharonb@csufresno.edu and lneal@csufresno.edu