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Chacivity Nomination Form

Please fill out the form below to nominate a student for the Chacivity Award. All fields are required, except as noted.

Nominee

 
 

 




(Optional)



 

 


 

 

Person Completing Nomination Form

 

 





 



  • Student Affairs Division
  • Sutton Hall, Suite 211-216
    1011 South Drive
    Indiana, PA 15705
  • Phone: 724-357-4040
  • Fax: 724-357-4977
  • Office Hours
  • Monday–Friday
  • 7:30 a.m.–12:00 p.m.
  • 1:00 p.m.–4:30 p.m.