OUTSTANDING STUDENT NOMINATION FORM

PART B- To be completed by nominated student

The Student of the Month Selection Committee of the Merced College Faculty Senate cordially requests that you complete this form as a candidate for Merced College Student of the Month.

NAME: _______________________________________________________ TELEPHONE:                                      CELL PHONE: ________________
                        First                                        Last

STUDENT ID:                                                                                                                           

Email Address; __________________________________________________

Mailing Address: ________________________________________________

 Nominated by:                                                                                                                     

SEMESTERS AT MERCED COLLEGE (circle one): 1   2    3   4     5    6   Beyond   

Please take a few moments to develop a brief, type-written composition addressing the following questions:

A.      Introduction

1. Who are you?
2. Where are you from?
3. Where do you live?
4. What are your interests?

B.       Describe your academic record:

1. GPA
2. Semester enrolled
3. Work at other institutions
4. Honors/Awards/Committees – school and others

C.       Your educational goals and how Merced College is helping you to achieve these goals.

D.      Your professional goals:

1. What do you plan to do upon completion of your work here at Merced College?
2. Why did you select Merced College to obtain your course work?
3. Describe any extra curricular activities in which you are engaged.

 If you are selected, you will be invited to attend the College Board of Trustees meeting where you will be presented:

A.                  A certificate

B.                   A $50.00 check

C.                   A permit to park in Student of the Month parking place for one month

 Please return this form to the instructor who placed you in nomination.

Deadlines:

Return to Student of the Month Home Page

Last updated on 8/15/11 by Julie Clark