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Distinguished Student Leader Official Nomination Form

The Distinguished Student Leader award is annual award given to a student who has shown exemplarily leadership on campus. The individual(s) should have a variety of experiences that show progress in responsibility and commitment. The student should have maintained a good academic standing while contributing to the co-curricular programs of Western. To nominate such an individual please fill out the following form.

If you wish to nominate someone for the Distinguished Student Leader award, please fill out the information below. The selection committee will go over all of the applications for selection. Students, Faculty, and Staff are all welcome to make a nomination.


In order to qualify for the Distinguished Student Leader award, students must have:

  • Minimum cumulative grade point average of 2.5
  • An academic classification of junior or senior during the 2013-2014 academic year.
  • Demonstrated continuous involvement and have made contributions to the campus.

Other considerations:

  • A student's involvement and contributions to a community group or organization.
  • A recognition of the variety of leadership activities and participation in the student's co-curicular activies (i.e. intercollegiate athletics, theater, musical groups, student organizations, etc.)


Student Nominee Information

Student's First Name:


Student's Last Name:

Student V# (Required)


Nominator Name (First and Last):


Person Making Nomination E-mail (required):


Relationship to Nominee:



What qualities or experiences make this person a distinguished leader?


Please list the name and contact information for at least two other people that can speak to the experiences of this person:


Thank you for completing this nomination!


  This submission form is submitted via e-mail. On the next screen, you'll be asked to verify the information you submitted above. You will NOT receive any e-mail notifications that the nomination went through, but know that it did!



Student Leadership and Activities 503-838-8261 | or e-mail: