MOY Application

Section 1: Nominator/Advisor Information

First Name*:

Last Name*:

Affiliation:

Address:

City:

State:

Zip Code:

Work phone*:

Email*:

Section 2: Student Nominee Information

First Name*:

Last Name*:

College/ University*:

Address*:

City*:

State*:

Zip Code*:

Phone:

Email*:

Member #:

Student must be a SHAPE America member. Nominees who are not yet members may still be nominated as long as membership form is submitted within one month of nomination.

Section 3: Degree of the Student

Degree:

Adapted Physical Education

Athletic Training

Exercise Science

Fitness/Wellness

Health Education

Kinesiology

Physical Education

Sport Coaching

Sport Management

Other

Other:

Please specify

Section 4: Year in School

Year in School:

Junior

Senior

Section 5: Service Projects

Projects:

Please list at least 3 contributions to school or community:

Major of the Year Application Form

Annual Conference

SHAPE America

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