Wufoo

The deadline for nominations is February 27, 2012

Please use this nomination form for either Individual Mentoring Award Nominations for a specific faculty member or for the Culture of Mentoring Nomination for a specific mentoring program, only filling in the appropriate section for each. Please complete ALL fields within the appropriate sections. Last, please complete the section describing yourself as the nominator. When finished, click Submit at the bottom of the page.

Please click on the link to review the Criteria for Nominations http://mentor.usc.edu/mellon-awards/

No paper nominations will be accepted.
Mentoring Award Categories
Select Nomination Category *
Faculty to Faculty Faculty to Postdoctoral Fellows --- New this year! Faculty to Graduate Student Faculty to Undergraduate Student Culture of Mentoring Award
Nominee Information

Nominee's Name * First Last
Nominee's Phone Number * ### - ### - ####
Nominee's Email Address *
Nominee's Department/School *
Reason for Nomination (not applicable for the Culture of Mentoring Award)

In the box to the left, please be thorough and very specific as you illustrate the depth and quality of the mentoring relationship with your nominee. Give examples of how the mentoring relationship benefited you, particularly if it resulted in tangible outcomes. Remember to address as many of the characteristics appearing in the call for nomination as are pertinent. To strengthen your nomination, please include any other remarkable mentoring characteristics of your nominee. (Feel free to write text in MS Word and then cut and paste in the box below.)
ADDITIONAL LETTERS OF SUPPORT

You must solicit at least two additional letters of support for your nominee. These additional letters may come from other mentees, the nominee's (or your) chair, or the nominee's (or your) dean. Letters of support should be no longer than two pages.

To preserve the confidentiality of the letters’ contents, these letters must be sent in electronic format by email directly to ltmedina@usc.edu before the February 27, 2012 deadline with MELLON MENTORING AWARD LETTER and the NAME of the nominee in the subject heading.
Culture of Mentoring Award
Detailed Information on the Program You are Nominating

In the box to the left, please provide a minimum of two paragraphs about the Program you are nominating for the Culture of Mentoring Award. Please be thorough and very specific as you illustrate the depth and quality of the mentoring provided by the program you are nominating. Eligible programs may be administered at the Departmental, School or Institute Level, or may be based in some other type of organized unit. Give concrete examples of how the mentoring program benefited either you directly or others you have witnessed, particularly if it resulted in tangible outcomes. Mentoring programs are structured programs with a commitment to the development and success of effective mentoring of your faculty and the mentoring culture at those units.
Nominator information
Your Name * First Last
Your Email *
Your Phone Number * ### - ### - ####
Your Position *

(faculty, graduate student, undergraduate, other)
Your Department/School *
Are you a member of the Mellon Mentoring Forum? *
No Yes
If you are nominating someone who is/was your mentor, when were you mentored by the nominee?
You will receive an email confirmation of your submission. If you don't receive one, your submission is not complete.

If you experience problems with the nomination form, please email your completed form to ltmedina@usc.edu
Do Not Fill This Out

Wufoo

The deadline for nominations is February 27, 2012

Mentoring Award Categories

ADDITIONAL LETTERS OF SUPPORT

Culture of Mentoring Award

Nominator information

You will receive an email confirmation of your submission. If you don't receive one, your submission is not complete.