Please complete one for each nomination for each award by typing or writing clearly.

1.  Award:____________________________________________________

2.  Name of Student: _____________________________________________

3.  Current contact information (address, phone, e-mail)

____________________________________________________________

____________________________________________________________

4.  Student I.D.#________________________________ G.P.A.____________

5.  Degree Program ______________ Department: ______________________

6.  Undergraduate Institution: ______________________________________

7.  Semester admitted to UM Graduate School: __________________________

8.  Other graduate work: _________________________________________

9.  Previous Scholarships or Awards: _________________________________

__________________________________________________________

10.  Advisor: _________________________________________________

Rank order of Department nominees: Nomination # __________ of __________Nominations for this award category. (Students may be nominated for more than one award.)

FOUR copies of all material must be submitted for EACH nomination for EACH award. Incomplete applications will not be processed.

Deadline for applications to be returned to the Canadian-American Center:
MARCH 15th

For more details about the awards and fellowships and about the application process, contact the Canadian-American Center. (207) 581-4220

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