Gold Torch Award Application

Chapter name

College/University

Silver Torch Award honors chapters that meet minimum standards, as outlined in the Bylaws.

Gold Torch Award honors chapters that meet all the requirements for the Silver Torch Award, meet minimum selection and acceptance standards and go beyond the minimum, exemplifying scholarship, leadership and service. A chapter must apply or be nominated to receive this award.

Chapters pursuing the Ruth Weimer Mount Chapter Excellence Award must submit an additional and separate application at http://www.jotformpro.com/mortarboard/RWM

CONTACT INFORMATION of person completing this form

Full name

Position

Email address

Phone number

ADVISOR CONTACT INFORMATION

Name

Email address

Phone number

How has the chapter excelled in the area of scholarship?

How has the chapter excelled in the area of leadership?

How has the chapter excelled in the area of service to the alma mater?

Is there any other information that should be considered in the review of this nomination?

Please attach supporting documents as desired

I understand that in order to be eligible for this award, my chapter must submit all required reports and have all fees paid by May 15 and that I must submit a separate and additional application to be considered for the Ruth Weimer Mount Chapter Excellence Award.

Acknowledgement

Street Address
Street Address Line 2
Initials	Date
Postal / Zip Code	Country