2013 Dr. Charlie Nelms Community Contribution Award for a Student Nomination Form

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The Dr. Charlie Nelms Community Contribution Award for a Student is awarded to one University of Michigan-Flint student for significant contributions made to the greater Flint community through service projects and civic engagement.

Nominee

First Name *

Last Name *

E-Mail Address

Class Standing

Major

Community Involvement/Civic Engagement *

Additional Information Please provide any additional information on the nominee you feel necessary.

Nominator

First Name *

Last Name *

E-Mail Address *

Would you like the Nominee to know you nominated them? * YesNo

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Student Organization Center | 213 University Center - 303 East Kearsley St. | Flint, Michigan 48502
Phone: 810.424.5316 | Fax (810) 762-3023 | Dept.Student_Life@umflint.edu

University of Michigan-Flint

2013 Dr. Charlie Nelms Community Contribution Award for a Student Nomination Form

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