Candidate to be Honored as an Exemplary College or University Committed to Diversity for Year 2015 a...

Candidate to be Honored as anExemplary College or UniversityCommitted to Diversity for Year 2019 at

MINORITY ACCESS’ TWENTIETH NATIONAL ROLE MODELS CONFERENCESeptember 26 - September 29, 2019

Gaylord National Resort & Convention Center

201 Waterfront Steet

National Harbor, MD 20745-1135

Response Form

College/University*

President*

Address*

City*

State*

Zip Code*

Please indicate below your response

Our institution is not committed to diversity.Our institution is committed to diversity, however, our diversity efforts have not been successful enough to merit our being cited by Minority Access as an exemplary College or University Committed to Diversity.Our commitment to diversity & efforts to implement diversity - in our opinion - qualify us to be cited by Minority Access as an exemplary College or University Committed to Diversity for Year 2019 and to serve as an example for other institutions.

Accordingly, I nominate our institution to be cited & honored at the National Role Models Conference. Information about our diversity initiatives, efforts & results will be submitted by the appropriate person responsible for oversight and/or implementation of our diversity plan. The name and contact information for this individual are as follows:

Name*

Prefix

Title*

Department*

Address

Phone*

Fax

E-mail*

Submitted by*

Date*

Date

Title*

E-mail*

Attached a two/three page overview about your Diversity Department. (Attach Word Format Only)

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