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Honorary Degree Nomination Form

Please submit your nomination using the online form below. Note that you must complete all mandatory fields (indicated by the asterisk), including the consent checkbox at the bottom of the page or the nomination will not be submitted. It is recommended to save your answers in a word document before submitting.

Once submitted, you will receive an email confirmation. If you do not receive this confirmation, please contact Abby Blaszczyk, Executive Assistant – Scheduling & Governance at abbyb@nipissingu.ca or 705-474-3450 x4285.

Nominations may be submitted at any time but are considered by the committee only twice per year. Nominations are submitted in strict confidence and should therefore not be discussed with the intended nominee.

Please note that incomplete nominations will not be considered.

Nominee Information
Please provide the contact information of the individual you are nominating.
If the nominee has an association with and/or has provided significant service to Nipissing University, please provide a brief description (100 words maximum)
List and provide sources for your information. Examples include academic background, degrees held including honorary degrees (100 words maximum)
List and provide sources for your information. Examples include positions held, with dates if available and any other honours (100 words maximum)

Additional Accomplishments

Letters of Support (optional)

Two letters of support can be submitted from individuals who are familiar with the candidate’s achievements. The letters should state the relationship of the writer to the candidate and should complement the information provided on this form by providing a broader context for the candidate’s accomplishments and their impact. Please ensure that individuals supplying these letters are informed of the need to maintain strict confidentiality. Letters of Support may be sent separately to abbyb@nipissingu.ca.

Letter of Support #1

One file only.
5 MB limit.
Allowed types: txt rtf pdf doc docx.

Letter of Support #2

One file only.
5 MB limit.
Allowed types: txt rtf pdf doc docx.
Nominator Information
Please provide your contact information.
Additional Documents (optional)
Maximum 5 files.
5 MB limit.
Allowed types: txt rtf pdf doc docx odt ppt pptx.
Consent
FIPPA Statement
The information on this form is collected under the authority of the Nipissing University Act, 1992, and is in accordance with sections 39, 41 and 42 of Ontario’s Freedom of Information and Protection of Privacy Act (FIPPA). It is related directly to and required by the University to support your nomination for a Nipissing University Honorary Degree, and it will be used for no other purpose without consent. If you have any questions about the collection, use and disclosure of this information, please contact Nipissing's Access & Privacy Office at fippa@nipissingu.ca or by telephone at (705) 474-3450 ext. 4307.