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PSRSLA Nomination
Nominee
*
Indicates required field
Institution
*
Nominees should be
juniors or seniors.
Only
one
student can be nominated from each institution.
Department
*
Nominee's Name
*
First
Last
Full name of the student as it should appear on the certificate. If you want to include the middle name, type it after the first name.
Rationale for the Nomination
*
Description of why this student most deserves this award, i.e. how the student promotes the study of Russian and models the behavior of a committed Russian student. The student need not have the top GPA, nor be a Russian major, but should demonstrate an active dedication--in course work, outside activities, attitude--to the study of Russian language and culture.
Nominator(s)
Since the nomination should reflect the consensus of the program or department, the letter should be submitted by
department chair,
or director of undergraduate studies, or language program director.
Name
*
First
Last
At least one nominator must be an ACTR
member with dues paid at least through April of the current calendar year.
Join/renew now!
Position
*
Nominator's Institutional Email
*
ACTR member with dues paid through April of the current calendar year?
*
Yes
No
Name of 2nd Nominator
*
First
Last
Name of 3rd Nominator
*
First
Last
Position
*
Position
*
Email
*
Email
*
ACTR member with dues paid through April of the current calendar year?
*
Yes
No
ACTR member with dues paid through April of the current calendar year??
*
Yes
No
Would you like to receive the certificate
*
electronically only
by mail only
Nominator's mailing department address for the certificate
*
Line 1
Line 2
City
State
Zip Code
Country
Additional notes to the Committee
*
Submit