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* 1. First Name

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* 2. Last Name

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* 3. Institution

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* 4. Title

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* 5. Address 1

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* 6. City

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* 7. Country

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* 8. Phone:

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* 9. Email:

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* 10. Nominee's Supervisor's Name ( if known)

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* 11. Nominee's Supervisor's Phone Number (if known)

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* 12. Nominee's Supervisor's Email Address (if known)

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* 13. Please explain how this member has made outstanding and noteworthy contributions to the profession of internal auditing in higher education. Consider how the individual has moved the "internal audit" needle during their career.

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* 14. Attach Additional Documents for Specific Reasons for Nominations Here

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* 15. Below are examples of how a member can meet the award criteria. Please elaborate on how the member may have contributed in the following areas, if applicable (use boxes below).

a. supporting the success of internal audit through service to the profession of internal auditing in higher education;

b. advancing internal audit's role or reputation within a higher education organization or throughout an individual's career;

c. creating wider recognition of the need for and value of internal auditing in the governance and administration of an institution of higher education;

d. sustaining efforts to promote cooperative relationships and information exchange among internal auditors in higher education;

e. promoting the establishment and maintenance of high professional standards for internal auditors in higher education; and/or

f. sustaining service to higher education or internal audit professional associations in various roles: officer, board member, committee chairperson, committee member/participant, or presenter/instructor, etc. Higher Education or internal audit professional associations include and are not limited to: Institute of Internal Auditors, Women in Higher Education, Information Systems Audit and Control Association, American Association of Colleges & Universities.

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* 16. Other comments?

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* 17. Can a member of the Awards Committee contact you for more information?

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