Information that you will be asked to provide in the Nomination & Reference Portal includes:
Your Full Name:*
Your Email:*
Your Phone Number:
Basic Information
Name of the nominee:*
Class Year:
Email Address:
Your relation to the nominee:*
Name of individual who asked you to fill out this form:*
Award Category
Category you are nominating this individual for:* (Choose one)
White Key
Phalanx Honor Society – Regular Membership
Phalanx Honor Society – Honorary Membership
David M. Darrin ’40 Counseling Award
For White Key & Phalanx Honor Society – Regular Membership
Clubs/Organization Involvement
This section is required to be completed at least once and may be completed a maximum of five times.
Club/Organization Name:
Club/Organization – Years of Involvement:
Rating of Contribution/Involvement:
Explanation of Rating:
Summary
Briefly describe your impression of the person of interest in terms of: leadership, service, and devotion to their alma mater. This section can be skipped of a letter of reference is attached and sent to phalanx@rpi.edu
For Phalanx Honor Society – Honorary Membership
Please describe in detail the nominee’s contributions to Rensselaer Polytechnic Institute during his/her time here.*
For David M. Darrin ’40 Counseling Award
Please describe in detail the nominee’s counseling of undergraduate students that qualifies him/her for this award.*
*Required fields