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2012 Ally of the Year Nomination
Presented by the LGBT Caucus at Virginia Tech
Nominee's Contact Information
Name
Local Address
Email
Phone
xxx-xxx-xxxx
Cell Phone
xxx-xxx-xxxx
Connection to University
Student
Faculty
Staff
Alumnus
Community Memeber
If nominee is a student or alumnus:
Class Year
Major(s)
Minor(s)
If nominee is faculty or staff:
Position/Title
If nominee is a community member:
Relationship to Virginia Tech
Recommendation:
What makes this nominee a compelling candidate for Ally of the Year? (500 words or less)
Nominator's Contact Information
Name
Address
Email
Phone
xxx-xxx-xxxx
Cell Phone
xxx-xxx-xxxx
I am a/an
Faculty/Staff
Alumnus
Student
Other
Please enter the letters displayed:
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