Enrollment Management

The Derryberry Award Sample

Sample 2016 Derryberry Award Nomination Form

Nominee's Name: John Doe T #: T00001234
Home Address: 1234 Peach Street Baxter, TN
Parent(s)/Guardian: Mr. & Mrs. David Doe Parent(s) Phone: (931) 123-4567
High School: Cookeville High School ACT Composite Score: 32
TTU Major: Engineering Overall GPA: 4.0 Graduation Date: June 2004
TTU Box: 1234 Local Address: 12 Willow Cookeville
Local Phone: 372-3999 E-mail Address: Jdoe42@students.tntech.edu
Nominated By: Martin Dean Department: Chemical Engineering
Nominee hereby grants permission for TTU to issue press release if finalist or winner
(please sign): Yes No

In support of the nominee, please profile information in the following categories. If additional space is needed, please attach pages to this form.

A. Awards/Honors/Recognitions

Scholarship Awards

Avery Dennison Scholarship
Fall 1995-Spring 1999, Fall 2000-Spring 2001
Corporate scholarship

University Academic Scholarship
Fall 1995-Spring 1999, Fall 2000-Spring 2001

William D. Robinson Engineering Scholarship
Fall 1995-Spring 1999
Awarded through the Engineering Scholarship Awards Program

Honors and Awards

Chemical Engineering Outstanding Junior of the Year Award
Spring 1997
Chemical Engineering students are nominated for this award by the faculty and the winner is chosen by the students in the department. The award focuses on scholarship, campus involvement, and volunteer activities.

Student Government Association Legislation of the Year Award
Spring 1996
SGA senate members are nominated for this award by their fellow senators and the winner is chosen by the SGA executive officers.


Associated Scholars Guild Outstanding Big Sibling Award
Nominated (award to be announced), Spring 1998

Barry M. Goldwater Scholarship
A Tennessee Tech Nominee, Spring 1997

Omicron Delta Kappa Leader of the Year Award
Nominated, Spring 1996

Omicron Delta Kappa Sophomore Scholarship Award
Nominated, Spring 1996

Outstanding Honors Freshman Award
Nominated, Spring 1999

B. University Activities/Leadership Roles/Sports Programs

University Activities

American Institute of Chemical Engineers
Spring 1995-Spring 2001
AIChE is a chemical engineering student organization that focuses on professional development, department social activities, and service activities.

Tennessee Tech Honors Program
Fall 1995-Spring 2001
The TTU Honors Program is an independent university program designed to provide unique learning opportunities to help its student-members achieve their
full academic potential.

Associated Scholars Guild
Fall 1995-Spring 2001
The ASG is the student organization associated with the Tennessee Tech Honors
Program. The ASG provides opportunities for its members to participate in a
wide variety of academic, social, and professional development activities within
the framework of the TTU Honors Program.

Leadership Committee
Fall 1995-Spring 1999
The Leadership Committee works with the president of the student body and President Bell's aide in charge of faculty committees, keeps Honors students informed of the structure and role of these committees, and encourages Honors students to serve on these committees.

Tutors Committee
Fall 1996-Spring 1997
The committee finds people within the Honors program who are willing to tutor in a subject (often members of the committee) and directs them to people who need tutoring in that subject.

Social Committee
Fall 1995-Spring 1999
This committee organizes and oversees all ASG social activities.

Intramurals Committee
Fall 1995-Spring 1998
This committee organizes and supplies participants for the ASG intramurals activities.

ASG Big Sibling
Spring 1996-Spring 2001
Big Sibs help freshmen adjust to the Honors Program and college life in general by answering questions and accompanying them to Honors Program activities.

Peer Mentoring
Fall 1997, Fall 2000
ASG peer mentors assist Honors faculty through activities ranging from grading quizzes to leading classroom discussion.

Honor Societies:

Kappa Mu Epsilon
Spring 1997 -Spring 2000
Kappa Mu Epsilon is a national mathematics honors society with the primary mission to promote the interest of mathematics among undergraduate students. The chapters' members are selected from students of mathematics and other closely related fields who have maintained standards of scholarship, have professional merit, and have attained academic distinction.

Mortar Board
Spring 1997 -Spring 2001
Mortar Board is a national honor society that recognizes college seniors for distinguished ability and achievement in scholarship, leadership, and service.

Omega Chi Epsilon
Fall 1997-Spring 2001
Omega Chi Epsilon is the TTU Chemical Engineering honor society that promotes the academic and professional development of its members.

Omicron Delta Kappa
Fall 1997-Spring 2001
Omicron Delta Kappa is the national leadership honor society for college students, faculty, staff, administrators, and alumni that recognizes and encourages superior scholarship, leadership, and exemplary character.

Phi Kappa Phi
Spring 1998-Spring 2001
Phi Kappa Phi is a national honor society with the mission to recognize and promote academic excellence in all fields of higher education and to engage the community of scholars in service to others.

Tau Beta Pi
Spring 1998-Spring 2001
Tau Beta Pi is the Tennessee Tech engineering honor society. It is the only honor society representing the entire engineering profession.

Tennessee Board of Regents Student Affairs Sub-Council
Fall 1997-Spring 1999
The function of the sub-council is to address concerns within the jurisdiction of student affairs with the intent to promote the improvement of such matters on TBR campuses.

Academic Competition Club
Fall 1996-Spring 1999
The ACC is a student group whose members compete in academic tournaments/trivia bowls against other universities’ students.

American Chemical Society
Fall 1996-Spring 2000
The ACS is a student group for students with an interest in chemistry. The society hosts guest speakers from the chemical industry, promotes student research, and fosters professional development.

Foil, Epee, and Saber Society
Spring 1995-Fall 1996
The FESS provides student-fencers an opportunity to practice their fencing with other students interested in foil, epee, and saber fencing.

University Committees:

Student Affairs Committee
Fall 1999-Spring 2001

Vision Committee
Fall 1998-Spring 2000
The Vision Committee was an ad hoc committee formed by President Bell to replace the former Tennessee Tech vision statement with the current vision statement.

Marketing Committee
Fall 1998-Spring 1999

Outstanding Faculty Award Committee
Spring 1997, Spring 2000

Administrative Council
Fall 1998-Spring 2000

Student Government Association Committees:

Student Affairs
Fall 1997-Spring 1998
The SGA Student Affairs Committee reviews and disseminates SGA legislation concerning the general welfare of the student body.

Internal Affairs
Fall 1996-Spring 1998
The SGA Internal Affairs Committee is charged with upholding the integrity of the SGA constitution by reviewing all potential amendments. In addition, the committee holds any necessary SGA member misconduct hearings.

Leadership Roles:

Student Government Association:
Fall 1999-Spring 2000
The president of the SGA serves as the acknowledged head of the student body in all student affairs and student relations with the faculty, the staff, and the administration.

Secretary of Student Affairs
Fall 1998-Spring 1999
The SGA Secretary of Student Affairs is charged with representing the general welfare of the students on the SGA cabinet. The chief duty of this office is to serve as the appointed advisor to the SGA president for all matters pertaining to student life and well-being.

Fall 1996-Spring 1999
The SGA Senate drafts, debates, and votes on all Student Government
Association legislation. (Served as a Freshman Senator and a Senator from the College of Engineering)

Student Affairs Committee, Chair
Fall 1997-Spring 1998
The chair of the Student Affairs Committee sets the agenda for the committee and updates the president on all matters of concern to the committee. (See university activities above for description of committee.)

Internal Affairs Committee, Vice-Chair
Fall 1996-Spring 1997
The vice-chair of the Internal Affairs Committee assists the chair in fulfilling his/her duties, primarily by conducting meetings in his/her absence. (See university activities above for description of committee.)

American Institute of Chemical Engineers, President
Fall 1999-Spring 2001
Duties of the president include leading the AIChE meetings, coordinating student
activities with the faculty, and organizing and overseeing AIChE conference
activities. (See university activities for description of AIChE)

Tennessee Council of Student Presidents, Chair
Fall 1999-Spring 2001
The Council consists of student presidents from each TBR school, the Tennessee
Higher Education Committee student member from TBR, and the TBR student
member. Meeting monthly during the academic year, the Council reviews and
discusses pertinent campus-related issues. Responsibilities of the chair include
conducting all meetings and executing all council events or functions.

Academic Competition Club, Vice-President
Fall 1997-Spring 1998
The vice-president of ACC assists the president with organizing tournament activity and leads practice when the president is unavailable. (See university activities for description of ACC)

Mortar Board, Communications Chair
Fall 1999-Spring 2000
The Mortar Board communications chair is tasked with overseeing the membership nomination process as well as all communication with the new candidates for membership. (See university activities for a description of Mortar Board.)

Associated Scholars Guild, Vice-President
Fall 1998-Spring 1999
The vice-president’s primary duty is to chair the ASG Steering Committee, the
governing committee of the Associated Scholars Guild. The vice-president is also
tasked with being the chief assistant to the ASG president. (See university activities for a description of the Associated Scholars Guild)

Associated Scholars Guild Steering Committee
Fall 1998-Spring 1999
The ASG Steering Committee reviews all matters affecting the operation or
organization of the Associated Scholars Guild. Membership is selected both by
general election by the ASG membership and by appointment by the president.
(See university activities for a description of the Associated Scholars Guild)

Associated Scholars Guild Leadership Committee, Chair
Fall 1997-Spring 1998
The chair of the ASG Leadership Committee is charged with conducting all committee meetings, organizing workshops, and inviting guest speakers. (See
university activities for a description of the ASG Leadership Committee)

Tennessee Tech Honors Council
Fall 1999-Spring 2000
The Honors Council is the governing council for the Tennessee Tech Honors Program. Membership consists of both faculty and student-members of the Honors Program. The council is charged with approving the Honors curriculum, upholding the Honors charter, and reviewing all matters affecting the operation or organization of the Honors Program

C. Work Experience/Co-op Assignments/Campus Jobs

WebMD. L.L.C.
Spring 2001
Part-time employee in the Engineering and Technology Division at WebMD’s complex in Nashville, TN

Washington Internships for Students of Engineering
Summer 2000
(See achievements for description of this internship.)

BWXT Y-12, L.L.C.
Summer 1999-Spring 2000
Co-op assignment in the Engineering and Technology Division at Y-12 National
Security Complex in Oak Ridge, Tennessee

Cumberland County Quality Childcare Program
Summer 1997
Served as a childcare assistant for the CCQCP

D. Volunteer Activities

Department of Energy Tennessee State Science Bowl
Spring 2000, Spring 2001
Served as a scientific judge for the science bowl

South Cumberland Elementary Science Fair
Spring 1999
Served as a science fair judge

Spring 1997-Spring 2000
Served as a tutor for chemistry, physics, and mathematics

Rural Cumberland Resources Board of Directors
Fall 1996
Rural Cumberland Resources is a not-for-profit organization supporting lower-income families by providing assistance with general education and the development of family skills

E. Other Achievements

American Institute of Chemical Engineers Southern Regional Conference
Spring 2001 (Melbourne, Florida)
Presented research entitled "The Generation-IV Nuclear Energy Systems Initiative and National Non-Proliferation Goals"

American Institute of Chemical Engineers National Conference (professional)
Fall 2000 (New Orleans, Louisiana)
Invited by the AIChE Nuclear Energy Division to present nuclear non-proliferation research at the AIChE professional conference, but was unable to attend due to school conflicts

Published Paper – "Addressing Proliferation Concerns for a New Generation"
August 1999
Published in the Journal of Engineering and Public Policy

American Institute of Chemical Engineers Featured Speaker
June 1998
Featured speaker at the AIChE District of Columbia sectional meeting – topic of
the presentation was "Department of Energy Nuclear Initiatives and National
Non-Proliferation Policy"

Washington Internships for Students of Engineering
Summer 2000
Through WISE, up to sixteen third-year engineering students are invited to conduct research on a topic of their interest and of professional interest to their sponsoring societies. Throughout the ten weeks, the interns interact with leaders in the Congress and the Administration, industry, and prominent non- governmental organizations. Meetings with congressional Committees, executive office departments, and corporate government affairs offices are daily activities.

Department of Energy Internship
Summer 1998
Selected for an internship with the DOE in the District of Columbia headquarters (the internship was declined to allow for my co-op assignment)

Tennessee State Honors Conference
Spring 1998 (Nashville, Tennessee)
Presented research entitled "The Success of a Student-Run Honors Program"

American Chemical Society National Conference
Spring 1997 (San Francisco, California)
Presented research entitled "The Myers-Brigg Type Indicator for Chemistry

Playing the Banjo
Improving – slowly, but surely