Office of the Dean of the Faculty, Claremont McKenna College

William F. Podlich Distinguished Fellows Program - Nomination Form
2008-2009

Use this form to nominate an individual for the Distinguished Fellows Program. All information will be kept strictly confidential.
NOMINEE INFORMATION:
Name*
Title *
Discipline *
Institution*
Phone *
Address *
NOMINATOR INFORMATION:
Nominator *
Title *
Discipline *
Institution *
Phone *
Address *
DOCUMENTATION:
Nomination deadline for receipt of materials is October 15, 2008. Nominations should include the following materials: Curriculum Vitae Nomination Letter These materials can be submitted via this form (below) in Microsoft Word, text file, or PDF or via e-mail at podlichfellows@claremontmckenna.edu.
FILE UPLOAD: (Errors will result if the same document is attached multiple times).
Curriculum Vitae Nomination Letter
Verification* (Please enter the characters that you see in the image below.)