Service Award Nomination

Scholarship for eureka Potential

Do you know of students who are outstanding servant-leaders? More than deserving of a special award to recognize their service? Please nominate them for this $1000 award at Eureka College. You can nominate as many deserving students as you want (we will contact them but feel free to let them know you've nominated them!) but only one at a time.

Please tell us about the student you are nominating:
Last Name:	*required
First Name:	*required
Street Address:
City:
State/Province:
Zip/Postal Code:
E-mail:
Phone Number:
School Attending:
Entry Term:	Fall Spring Year
Year in School:
Why do you recommend this student for the award:
Please tell us about yourself:
Last Name:	*required
First Name:	*required
Street Address:	*required
City:	*required
State/Province:	*required
Zip/Postal Code:	*required
E-mail:	*required
Phone Number:	*required
Relationship to student: