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Please use the form below to nominate a DSLCC faculty member whom you feel has made a positive impact on you, the college or the community at large.
We request either a phone number or e-mail address in the form, in case we need to follow up with you on your nomination information. Please rest assured that we will not send unsolicited e-mails, nor make unsolicited phone calls to your number. Thank you.

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* 1. Name of nominated faculty member. Choose only one faculty member from the drop-down list below:

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* 2. Rationale for Nomination: (Please provide a brief narrative describing the activity, behavior, or contribution for which the nominee is being nominated.)

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* 3. Your name

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* 4. Your phone number

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* 5. Your e-mail address:

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* 6. Date of submission:

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