Ivy Tech Community College of Indiana

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Nomination Form - Nominate Individual to Society of Innovators

Individuals are eligible to be nominated for Membership in the Society of Innovators. Finalists are eligible to be named Fellows. Fellows sponsored by ArcelorMittal, the K-12 Teacher Fellow by Center of Workforce Innovations.

Contact Information for Nominator -- Please fill out all contact information.
Nominator:		Title:
Company/Organization:		Area or Sector:
Address:		City, State, Zip:
Telephone:		Email:

All individuals and their innovations will be judged on this criteria:
*• A new or different way forward that challenges the status quo*
*• Visionary leadership*
*• Collaborative team player*
*• Willingness to take risks*
*• A lifelong learner*

Nominee:		Title or Job:
Company/Organization (Or self-employed):		Area or Sector:
Address:		City, State, Zip:
Telephone:		Email:

Check if Nominee is K – 12 Classroom Teacher

Reason for individual nominated:

Please limit to 750 Characters.

Please describe innovative product, idea and/or method:

Please limit to 750 Characters.

Please identify the phase of evolution of the innovative product, idea and/or method:
Idea Experimental In development Innovation launched

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Ivy Tech Community College
East Chicago, Gary,
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& Valparaiso
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