General OTM Nomination Form

Month:
February		 Year:
2010
Category:
Nominee's School:
Western Michigan University		 Region:
GLACURH
Nominee's organization:

Nominee:

Address:


Phone:

Email Address:

On-Campus Population:
4570
Nominator's organization:

Nominator:

Address:


Phone:

Email Address:

Chapter Size:
24

Please explain the outstanding contributions of the nominee during the month of nomination
(i.e., how the nominee addressed recognition, motivation, and support for you or your organization).

Word Count (600 Maximum):

World Wide Web nominations must be typed on this form and must not exceed 600 words.
Nominations not following this format may not be considered for a national award.
No additional material will be considered. Nominations must be submitted by midnight
on the th of the month following the month of nomination.

Revised May 1999