University Award for
Distinguished Undergraduate Student
in Research at Kansas State University
Instructions: First, save this document to your computer. Next, complete the form and save the
changes.
Nomination Form
(deadline: February 8, 2016)
Please provide the following information of the nominee (please print or type):
Name:
Phone:
Address
Email:
Current Classification:
Hours currently enrolled:
Sophomore
Junior
Senior
Most recent semester GPA:
Cumulative GPA:
Brief description of nominee’s past and present research at Kansas State University:
Name and address of person nominating the prospective candidate:
Name:
Address:
Phone:
Email:
Relationship:
Please write a nomination statement on a separate letterhead outlining the nature of activities
warranting this nomination for the past academic year.
Documentation supportive of this application must include:
a) letter of nomination
b) an abstract of research project for which student was nominated
c) summary of nominee’s research activities contributing to demonstrated excellence in
research in his or her field of study at Kansas State University
d) maximum of two written letters of support (must include name, address, title, phone
number and email of reference and relationship to nominee)
e) a current resume of nominee
f) an official transcript
Please submit one electronic copy (in Word or PDF) of the completed form and documentation
supportive of this application by Monday, February 8, 2016, to Gail Zeak (gaill@ksu.edu).