Student of the Month
Nomination Form
Please print and return form to the Student Services Office, J. Mantle Student Center, Weed Campus. May be
emailed to: StudentServices@siskiyous.edu
Name of Student Student “S” Number
Reason why this student should be Student of the Month
Does this student know that they are nominated? Yes No
May we share your nomination with this student? Yes No
Nominator Name Signature Date