Maverick of the Month Nomination Form

Nominate a student and/or faculty/staff member for the Maverick of the Month recognition. Sponsored by the UTA Ambassadors, the Maverick of the Month recognizes one student and one faculty/staff member each month for exemplifying what it means to be a Maverick.

The Maverick of the Month recipients truly embody the core values of The Maverick Way:
* Pride and Traditions
* Respect and Civility
* Diversity
* Involvement and Engagement
* Integrity
* Wellness

Visit www.uta.edu/maverickway for more information on The Maverick Way.

Nominee's Information
Name Name First Last
Email Address
Maverick of the Month Category:

Maverick of the Month Category: Student Faculty/Staff
Nominator's Information
Name Name First Last
Email Address
Phone Phone - ### - ### ####
If you are completing this nomination form to earn points for Spirit Week, which organization/team to receive the points?
Reason for Nomination
Select up to three (3) core values of The Maverick Way that the nominee best exemplifies.

Select up to three (3) core values of The Maverick Way that the nominee best exemplifies. Pride and Traditions Respect and Civility Diversity Involvement and Engagement Integrity Wellness
Describe how the nominee exemplifies the core values selected above.
Please list any student/departmental organizations/activities the nominee is involved in at UTA.
If known, please list any awards or accomplishments that would attest to the nominee's dedication to upholding the values of The Maverick Way.
Who recommended that you nominate someone for the Maverick of the Month distinction?

Maverick of the Month Nomination Form

Nominee's Information

Nominator's Information

Reason for Nomination