You are not signed in. Sign In

PSI CHI: The International Honor Society in Psychology

Awards/Grants

2009-10 Regional Faculty Advisor Award Submission Form

Deadline: 12/1/2009

Submission Instructions

Psi Chi chapters may nominate their faculty advisor for this regional award below. The award is intended to recognize actively involved Psi Chi chapter faculty advisors for their outstanding service to the chapter at the regional level. NOTE: At the end of this submission form is where you will upload your letter of nomination (see cover sheet for details).

More Information | Read Cover Sheet | Previous Winners

1. Name of nominated faculty advisor:

2. Title (i.e., PhD, PsyD, EdD, etc):

3. Faculty advisor's Psi Chi member ID number

4. Chapter (school) name:

Chapter Officer Information

5. Chapter officer preparing nomination:

6. Office held (i.e., chapter president):

Officer's Contact Information

7. Mailing address of officer | Street or PO Box:

8. City:

9. State:

10. ZipCode:

11. Phone:

12. Email:

School Mailing Information

13. School name:

14. School mailing address | Street or P.O. Box

15. City:

16. State:

17. ZipCode:

File Upload:

Below is where you will attach your letter of nomination to your submission. You will need to read this award's Cover Sheet for complete details on what information to include in this letter. The file format for the file submitted should be Microsoft Word, text, doc, or RTF. Questions or additional materials or files to accompany your submission should be sent to email.

18. Letter of Nomination (limited to 1,000 words)

Please use the following format for the file name:
school name.extension (i.e., abcschool.doc)