RCCI Nomination Form
Click here for a printable form

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

a. Name:
b. Title:
c. Institution:
d. Address:
e. City:
f. State:
g. Zip:
h. Phone:
i. Fax:
j. Email:

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:

PLEASE NOTE: Nominees will be contacted by the Regional Rural Development Centers and invited to submit a more formal application to join the RCCI.