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AU-East Africa Ambassador Nomination Form

Any individual or group may nominate an AU female student (freshman through junior) to participate in the program. An $80 entry fee (payable to Anderson University) must be campus-mailed to Cindy Sprunger. If sending the entry fee from off-campus, please mail it to: Cindy Sprunger, Anderson University, 1100 E. 5th St., Anderson, IN 46012. The nomination deadline is Jan. 22, 2010.

Nominee's Name:
Nominee's Phone:
Nominee's E-mail Address:
Your Name/Name of Group:
Address:City:
State:Zip:
Home Phone:Work Phone:
E-mail:


Reason for nomination:


 By checking this box, I agree to submit the $80 entry fee for this nomination.