FORUM ON THE GEOLOGY OF INDUSTRIAL MINERALS
Robert L. Bates Memorial Scholarship NOMINATION FORM
Please provide the following information on the nominee:
Name__________________________________________________________________
Address________________________________________________________________
Phone______________________e-mail_______________________________________
College/University_________________________________________________________ Class/Major_______________________________Most recent GPA________________
How has the nominee demonstrated commitment or leadership abilities related to geosciences in academic or community service organizations?

How has the nominee demonstrated a strong interest in or commitment to industrial minerals as a possible focus of his/her career?

How has the nominee demonstrated a high level of scholarship in general, and in the geosciences in particular?

Name of Nominator ________________________________________________________
Title ____________________________________________________________________
Affiliation ________________________________________________________________
Signature:

Please submit this form along with the student letter detailing her/his background and professional goals before February 1 of the Forum year to:

Robert L. Bates Memorial Scholarship Awards Committee
c/o George Edwards
6706 NW 18th Avenue, Gainesville, FL 32605
Phone & fax: 352-333-3184; e-mail: gedwards@atlantic.net.........................................<PDF Version>