2011 K. Patricia Cross Future Leaders Award

AAC&U Annual Meeting 2011

Thank you for your interest in the award. The deadline is Monday, October 4, 2010. Applicants will be notified in mid-December, 2010.

Please be sure to complete all fields in the three sections of this form:

Graduate Student Information
Information about individual submitting Letter of Nomination
Information about individual submitting Letter of Support

All four supporting documents--the Student Statement, Student Vitae, Letter of Nomination, and Letter of Support--must be received by AAC&U no later than October 4, 2010.

PLEASE NOTE: All applicants must provide two copies of the supporting materials – the original documents and one duplicate copy of each.

If you have any questions, please contact Suzanne Hyers at hyers@aacu.org. We look forward to receiving your materials.

(** indicates required fields)

GRADUATE STUDENT INFORMATION:

Prefix:
First Name:**
Last Name:**
Academic Discipline:**
Institution:**
Mailing Address 1:**
Mailing Address 2:
City:**
State:**
Zip code:**
Phone:**
E-mail:**

DECEMBER CONTACT INFORMATION
AAC&U will be contacting you in mid-December. Please indicate your mailing address at that time:

	I will be at the same address
	Please use the address below instead

Address 1:

Address 2:

City:

State:

Zip code:

Phone:

E-mail:

LETTER OF NOMINATION
Please complete the following information for the individual who will be sending the Letter of Nomination:

Prefix:
First Name:**
Last Name:**
Academic Title:**
Institution:**
Mailing Address 1:**
Mailing Address 2:
City:**
State:**
Zip code:**
Phone:**
E-mail:**

LETTER OF SUPPORT
Please complete the following information for the individual who will be sending the Letter of Support:

Prefix:
First Name:**
Last Name:**
Academic Title:**
Institution:**
Mailing Address 1:**
Mailing Address 2:
City:**
State:**
Zip code:**
Phone:**
E-mail:**
IMPORTANT NOTE: When this information is submitted online, you will receive an automatic email confirming its receipt. AAC&U will also send an email--on October 12--to every individual for whom we received a nomination. If you do not receive that second email from AAC&U, please contact us to make sure your materials were received.