Scholarship/Fellowship Nomination Form

Only one form is needed to nominate a student for multiple awards. Please only nominate students for scholarships that truly apply to them.

Please note: Membership numbers are listed on your monthly chapter roster. Nominations for all scholarships listed on this form must be received by Nov. 15 (except Vinod & Gail Sahney Scholarship which is due Dec 31). Fields marked in bold are required.

U.S. Territories/Canada/Mexico Only

                    

U.S. and International

                    
For questions, contact Elizabeth Grimes, Headquarters Operations Administrator at egrimes@iise.org or 770-349-1132  

  

The nominee's Information

 

Nominee's Name:

 

Complete Mailing Address:

 

Phone Number:

 

 E-mail Address:

 

Chapter Number:

 

Membership Number:

 

Current Academic Level: 


Expected Graduation Date (mm/dd/yyyy): 

 

Does the nominee have a minimum cumulative GPA of 3.40 on a scale of 4.00 (3.00 for the Lisa Zaken Award for Excellence)?

                            

 

For UPS Minority Scholarship: Is the nominee African American, Hispanic, Asian, or Pacific Islander, American Indian or Alaska Native?

                            

 

Your Information:

 

Nominator's Name:

 

Nominator's Title:

 

Norminator's School:

 

Nominator's Full Mailing Address:

 

Nominator's E-mail Address:

 

Nominator's Chapter Number: