Chapter Program of Excellence Award Nomination Form

Nomination Deadline: August 31, Annually

Chapter Program of Excellence Awards are presented to chapters that have organized an exceptional program during the year. Please complete this form to nominate your last year’s most successful chapter program/event. For questions, please contact chapters@sigmaxi.org

Chapter Information

Chapter Name: *

Chapter Website (if applicable):
You may also add a link to your Chapter Community.

Chapter Contact First Name: *

Chapter Contact Last Name: *

Chapter Contact Email: *

Position on the Chapter Board: *

Program Information

Program Name: *

Provide a brief description of the program, including goals and objectives. Emphasize innovative aspects of program: how has the program addressed a need, filled a gap, or allowed creative use of resources. *

Program Date: * +

Who is the target audience for the program? Select all that apply: *

Other target audience: *

What is the size of attendance/participation in the program?: *

Describe how the program engaged/involved chapter members. Was member engagement limited to attendance? Or did it extend to planning and organization? *

How was the program funded? Check all that apply: *

Fully sponsored by the chapter

Co-sponsored by chapter and host institution

External corporate sponsorship

External individual sponsorship

Other (please specify)

Other funding: *

Please describe the impact of this program on the vitality of your chapter and the broader community: *

Please upload any supporting documents such as flyers, announcements, testimonies, etc.
(Allowed file types: .pdf, .doc, .docx, .txt, .rtf, .jpg, .gif, .png, .tif, .zip)

Electronic Signature

By checking the box below, I attest that I am a chapter officer, authorized to make this submission on behalf of the chapter. *

I agree.

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