Nomination form for Diversity & Inclusion Award 2022
Attach this form, mandatory references and any additional information to edi.office@uu.nl.
1. Data of submitter Name and last name Email address Phone number
Position Student
Employee
Alumni
Other 2. Data of nominated group or person
Name and last name Email address Phone number
Position Student
Employee
Team Faculty
3. Answer the following questions (max 250 words) a. Describe the initiative and/or contribution of
the nominee(s) to a more diverse and inclusive university.
b. What is the (intended) scope of the initiative within Utrecht University?
c. Name the results of the initiative if already applicable.
d. Why are the efforts of the nominee(s) exceptional?
e. Please mention here any additional
information relevant to the Award committee 4. Attachements
Mandatory: Reference letter 1 Add reference letter 1 as attachment Mandatory: Reference letter 2 Add reference letter 2 as attachment Optional: Additional information If necessary, add additional information
as an appendix
