WK Award Nomination

Dr. Werner Kubsch Award

NOMINATION FORM The Dr. Werner Kubsch Award for Outstanding Achievement in International Education

	Instructions:

Complete Sections I - IV of the form.
Please limit your discussion in Section II to the Award Criteria selected.
With the exception of the nominee's Vitae, supporting documents should be directly relevant to the Award Criteria.
If mailing, send the completed nomination papers to:

John Halder, President
Community Colleges for International Development, Inc.
P.O. Box 2068
Cedar Rapids, IA 52406-2068
Nominations must be postmarked no later than Friday, November 20, 2009 or submitted via this web site by the same date.
Important: In recent years, successful nominations have been those that included a portfolio of the supporting documentation. Nominations that do not have supporting documents mailed to CCID may be at a distinct disadvantage. However, please keep the supporting documentation to a maximum of 20 pages as it has to be copied multiple times for the nomination committee members (electronic formats are welcome).
Please refer to the CHECKLIST below before submitting the nomination.

SECTION I

Nominee:
Institution:
Address:
City:
State:
Zip:

Nominated By :
Institution:
Address:
City:
State:
Zip:

In what capacity was the Nominee serving during the period for which achievement is cited?
Indicate the criteria in which the Nominee has excelled, and under which this nomination is submitted (multiple criteria are allowed):
A.	Contribution to the ability of 2 year college students to understand the impact of other countries and cultures on their daily lives.
B.	Expansion of opportunities for students to study overseas.
C.	Development or implementation of opportunities for faculty exchanges or study abroad.
D.	Development of linkages with educational systems or institutions in other countries.
E.	Development or participation in educational projects overseas which benefit educational systems or people in other countries.

SECTION II

Please include a file detailing how the nominee excelled in each of the Award Criteria selected in Section I. Do not exceed 500 words for each criterion selected. Additional supporting materials should be mailed or emailed to ccid@kirkwood.edu. Submissions short in supporting materials are clearly at a disadvantage.

SECTION III - Biographical Information Required for Dr. Werner Kubsch Award Nomination

Education: (The years, in which various qualifications were obtained must be stated)
Other training:
Membership in professional organizations:
Countries of work experience:

Employment records

Starting with present position, list, in reverse order, every employment held, and state the start and end dates of each employment
Clearly distinguish "employer" as an employee from the "client" for whom you have worked as a consultant or an advisor

Employer:
From:	To:
Position Title:
Description of duties:

Employer:
From:	To:
Position Title:
Description of duties:

Employer:
From:	To:
Position Title:
Description of duties:

Employer:
From:	To:
Position Title:
Description of duties:

Employer:
From:	To:
Position Title:
Description of duties:

If you are running out of space, please send the rest of the employment records in a separate document file to the following email: ccid@kirkwood.edu. PLEASE put the nominee's name in the subject line. Thank you.

SECTION IV

Please include a file containing a proposed citation of not more than 500 words to be read at the presentation of the award.

Kubsch Nomination Checklist:

Have all sections of the on-line application been completed?
Have you limited Sections II and IV to 500 words?
Has the nominee's Vitae been completed? And other supplemental information emailed?
Is there a support letter from your college president?
Have other support documents been mailed or emailed (articles, commendations, newsclippings, etc.)? Limit those to 20 pages please.
Have you met the November 20th, 2009 deadline?

Submissions which exceed the length specified will be rejected.

Dr. Werner Kubsch Award

Past Recipients & Nominees

CCID Home

CCID Executive Offices
6301 Kirkwood Blvd, SW
Cedar Rapids, Iowa 52404
United States of America
Phone (319) 398-1257
Fax (319) 398-7113
Email: ccid@kirkwood.edu