Outstanding Adjunct Faculty Award Nomination Form

Use this form to nominate an adjunct faculty member for the Geo2YC Division's Outstanding Adjunct Faculty Award. Self-nominations are welcomed.

Note: You need to fill out the form in one sitting. Leaving this page without hitting SUBMIT at the bottom will erase all of the data you have entered.

Nominator Information (leave blank if self-nomination)Your Name:

Your Email Address:

Nominee InformationName of Nominee:

Email of Nominee:

If email isn't the best way to contact the nominee, please provide us with a phone number or the best way to contact them.

Name of two-year college where this person teaches:

Classes Taught by Nominee:

The intent of this award is to recognize part-time instructors who inspire their students and colleagues with their dedication and passion for teaching geoscience at two-year colleges. Please comment on how this person contributes to the two-year institution and its students, how this person fills leadership and mentoring roles at your two-year college, and/or any other way this faculty member's passion stands out.

Institution InformationThe committee would like to verify the information provided for our award winners. Please name someone who can confirm the information above:

Contact email or phone number for the person named:

If selected as an outstanding adjunct instructor, the Geo2YC Division would like to highlight this recognition with the adjunct's administration and institution. We therefore request contact information for the appropriate college administrator as well as marketing office.

Name of Adjunct's administrator (Department Chair, Dean, President of Community College, etc.):

Email Address of Administrator (to receive a letter of recognition):

Name of representative from public relations office (or whatever office best fits):

Email address for public relations office:

Name Email

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