Your Name*
Name of Student Nominee*

Describe how the nominee has made a significant educational, social, and/or social justice impact on the Blackburn community through their participation in organizations, offices, clubs, or other relatable leadership engagements.*

Describe how the nominee has demonstrated ethical leadership and/or service to the Blackburn community or the community at large, e.g. through service to the college, community service, volunteerism, social justice, and/or civic engagement.*

Describe how the nominee displays commitment to trust, foresight, and empathetic listening among their peers in a way that advances a DEI perspective/approach that supports diversity at Blackburn.*

Share examples that express the nominee's "service first" attitude (to their peers and/or community, either at Blackburn or the community at large).*

Describe how the nominee demonstrates self-determination and/or perseverance in personal, social, professional, academic, and/or social justice endeavors.*