Dean of the Faculty

William F. Podlich Distinguished Fellows Program

Nomination Form

Use this form to nominate an individual for the Distinguished Fellows Program.
All information will be kept strictly confidential.
NOMINEE INFORMATION:
* Name
* Title
* Discipline
* Institution
* Phone
* Address

NOMINATOR INFORMATION:
* Nominator
* Title
* Discipline
* Institution
* Phone
* Address

DOCUMENTATION:
Nomination deadline for receipt of materials is November 21st.
Nominations should include the following materials:
  1. Curriculum Vitae
  2. Nomination Letter
These materials can be submitted via this form (below) in Microsoft Word, text file, or PDF or
via email at podlichfellows@claremontmckenna.edu.

FILE UPLOAD: (Errors will result if the same document is attached multiple times).
  1. Curriculum Vitae

  2. Nomination Letter

*Validation:
* = required fields