2015 FMA Nomination Form

2015 Distinguished Faculty Mentor Awards Nomination Form Awarded by the Graduate Assembly This award honors members of the Berkeley faculty who have shown an outstanding commitment to mentoring, developing, and supporting graduate students. Three awards will be presented to the faculty winners. The primary nominator must be a present or former graduate student; associate nominators can include undergraduates, postdocs or consist of jointly written letters. One award will be reserved for a faculty member or teaching staff from a professional degree program, if possible. For more guidelines and information on this year’s FMA, please visit: ga.berkeley.edu/fma. This nomination form and 3 letters of recommendation must be e-­‐mailed as a single email to [email protected] Hard copies of completed nomination packets can also be turned into the Graduate Assembly in Anthony Hall. If this nomination is being jointly submitted with other graduate students, please include their names and departments. Group letters, if submitted, must have an element whereby each contributor individually acknowledges the importance of the mentor to their work. Also, no more than three names (signatures) per letter will be accepted. Letters should NOT resemble a petition. We will not accept more than 3 letters. The Graduate Assembly must receive nominations by FRIDAY, February 6th, 2015 no later than 5 pm PST. FACULTY NOMINEE INFORMATION Name of Faculty Member You Are Nominating: __________________________________________________________ Faculty Member’s Home Department: _____________________________________________________________________ Faculty Member’s Email Address: __________________________________________________________________________ Faculty Member’s Telephone Number: ____________________________________________________________________ NOMINATOR(S) INFORMATION Nominator’s Name(s): ______________________________________________________________________________________ Home department(s) or graduate group(s): ______________________________________________________________ E-­‐mail Address(es): _________________________________________________________________________________________ Telephone Number(s): _____________________________________________________________________________________ Target Degree: _________________________________________________ Year in Program: ________________________ Nominator(s’) Initials: ____________________________________ Date: _________________________________________