Theodore “Ted” Johnson Outstanding Student Award Nomination Form Recipient will be awarded at the Black Student Convocation In 1953 Ted Johnson came to NAU as a history major and graduated in 1956. He returned to NAU in 1966 and received an M.A.T. in English in 1967. In 1969 he returned back to NAU to become the first African American faculty member in the university’s history. Throughout his thirty years (1969-1999) Professor Johnson taught composition, literature and minority literature. He served as an advisor to four campus organizations including Kappa Alpha Psi Fraternity. Professor Johnson was also very active in civil and political affairs in Flagstaff, Coconino County and Arizona. Professor Johnson headed up many committees in diversity and minority student needs. He was recognized with an Alumni Service Award as well as the Dr. Martin Luther King Jr. Achievement Award. More importantly, students sought him out as someone that they could talk to and someone who would listen and understand. Perhaps his greatest contribution to NAU was his quietest one—his influence on students of all backgrounds and his willingness to guide, support and educate students throughout his career at NAU. Name of Nominee:_________________________________ Local Address:____________________ City, State, Zip_______________ Email:___________________________ Local Phone:_________________ College:_______________________________________GPA:___________ Nominator Self-nominating Please describe on a separate sheet of paper in 250 words or less how you, as a Black student, believe you meet the criteria listed below for the Theodore “Ted” Johnson Outstanding Senior Award. Please include the following in your letter of support. • Academic accomplishments • Extracurricular activities and involvement with community activities • Career goals and ambitions Please describe on a separate sheet of paper in 250 words or less how you believe a Black student meets the criteria below for the Theodore “Ted” Johnson Outstanding Senior Award. Please include the following in your letter of support. Academic performance Employment performance, community service or extracurricular activities His/her overall potential Character, team orientation In what capacity do you know the nominee? Name of nominator:____________________ Title:_____________________ Mailing Address:__________________________ Phone:_________________ Please send completed form and letter of support to: Attn: Bernadine Lewis, Black Student Convocation Committee PO Box 15066 Flagstaff, AZ 86011-5066 Phone 928-523-5876 / Fax 928-523-6559 Bernadine.Lewis@nau.edu Deadline: April 30th by 5:00pm