RCCI Nomination Form

1. Please tell us about the person making the nomination:

a. Name:	______________________________________________________________________________
b. Phone:	______________________________________________________________________________
c. Email:	______________________________________________________________________________
d. Institution:	______________________________________________________________________________

2. Please tell us about the institution you wish to nominate:

a. Name of rural or tribal college:	___________________________________________________________
b. President's Name:	___________________________________________________________
c. Contact Information:	___________________________________________________________

3. Please tell us why you feel this college is a good candidate for the RCCI program:

a. Institutional structure is open to change:

 

 

b. Institutional leadership believes community is critical to the college's mission:

 

c. Institution has a history of successful partnerships:

 

d. Institution has a commitment to serving the needs of low-income people and to fostering diversity:

 

 

e. Institution has established, or is open to, a working partnership with the Cooperative Extension Service System that is part of its state's Land-Grant university/universities:

 

f. Other comments:

 

 

 

 

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