Nomination Form – Student Information to help you with your application. Queen’s is committed to the university’s equity goals as reflected in the Senate Educational Equity Policy, and invites nominations from all interested applicants including women, visible minorities/racialized group members, Aboriginal persons, persons with disabilities, and LGBTQ community members. Eligibility: Because of the demanding nature of committee obligations, it is recommended that students have a minimum GPA of 2.7. Biographical Information: Name: Click here to enter name. Email: Click here to enter email address. Degree Program and Plan (e.g. BAH, History; BSc, Chemical Engineering): Click here to enter degree program and plan. Graduating Year: Click here to enter graduating year. Please specify if you are an undergraduate or graduate student: Choose student type. Application Questions: (Please note that each answer should be limited to 500 words or less.) 1. Have you served on a university committee at Queen’s or elsewhere? Please provide the committee name, dates of membership, and particular duties (please do not use acronyms)? Click here to answer question 1. 2. Have you participated in other extra-curricular activities at Queen’s or elsewhere (e.g., athletic teams, orientation groups, volunteer efforts, etc.)? Please tell us about the activities in which you participated and your role and responsibilities. Click here to answer question 2. 3. What personal attributes or characteristics do you possess that will allow you to make a significant contribution to the Rosen Lecture Series Subcommittee? Click here to answer question 3. 1 4. What experience do you think you might gain from serving on the Rosen Lecture Series Subcommittee? Click here to answer question 4. 5. Applicants are invited to add any other additional information you may consider relevant. Click here to provide any other additional information as per question 5. 6. Please provide the names of two persons at Queen’s (not necessarily faculty) who would be willing to be contacted via email to support this application by providing a reference if necessary (please do not use acronyms): Click here to enter referee one name and email address. Click here to enter referee two name and email address. You should receive a confirmation by email that your application has been received within two working days. If you do not receive this confirmation, contact the Office of the Provost and Vice-Principal (Academic). If you have any problems or questions about the forms or the nomination process, please contact the Office of the Provost and Vice-Principal (Academic) at provost@queensu.ca or call 613-533-2020. Please be sure to include a correct return email address so we can reply to your query. 2