Student Leaership Center Roadrunner of the Month Nomination Form Student Leaership Center

Eligibility Qualifications for Nominees

Students may be nominated by a member of the faculty, staff, or any other student attending UTSA.

Completed nomination forms are due by the last Monday of each month by 4:00 p.m. The student will be notified and presented the award on the first Monday of the following month (ie: September winner will be honored on the first Monday of October).

**NOTE: Nominations received after the deadline will be considered during the judging process for the following month.**

Nominees's Information
Nominee's Name (First and Last):
Banner ID:    
Classification: Cumulative GPA:
Phone: Hometown or enter Unknown
Major Email:
Nominator's Information
Nominator's Name (First and Last):
Title: Department:
Phone: Email:
Relationship to Nominee
(i.e. Advisor, professor, Peer, etc.)
Please limit your response to 150 words.
How does the nominee exemplify leadership on campus? Please be specific.
Why do you think the nominee should be recognized as Roadrunner of the Month?
Please describe an event and/or an activity where you have seen the nominee's leadership skills in action.

If you have any questions or would like more information, please contact the Student Leadership Center at (210)-458-7967 / E-mail or come by the Student Leadership Center in the University Center Phase III in room 1.002.

Questions and Comments:
**REMINDER** Please print a copy for your personal records before submitting, in case of technical errors.*