Local Government Early Career Service Certificate Nomination Form

Local Government Early Career Service Certificate Nomination Form
The Local Government Early Career Service Certificate recognizes graduating students in good academic standing who have completed or are in the process of completing a major service project for a local government organization or who have served on the university's ICMA Student Chapter board in an officer role for at least a year. Students are nominated by their ICMA Student Chapter Faculty Advisor or another professor for their outstanding demonstration of a strong commitment to local government. Nominations happen twice a year (December and April) to accommodate winter and spring graduates.

Winter Graduate Nominations: Due December 1

Spring Graduate Nominations: Due April 21

For questions email careers@icma.org.
University/College Name *
Faculty Advisor/ Professor Name *

First NameLast Name
Faculty Advisor/ Professor Email *
Student Name *

First NameLast Name
Student Email *
Is the nominee a Winter or Spring Graduate?*
Date of Graduation *

MonthDayYear
Student Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Did this student serve in a leadership role within the student chapter?*

YesNo
If yes, please indicate the position they held.
Describe what the student accomplished in their student chapter leadership role.
(*Only for students being nominated for holding a leadership position not for those being nominated for a project they completed)
Describe the project the student completed.
(i.e. what organization did they complete the project for, what was the scope of the project, what were the goals and challenges of the project)
Why does the student deserve the nomination?*
Should be Empty: