Name

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About You

Let’s begin with some basic information so we can identify your application and contact you if needed.

Student Name*

First Last

SUNY Niagara Email Address*

Please use your SUNY Niagara student email address. Important application updates will be sent to this address.

Phone Number*

Enter the best phone number to use if we need to contact you about your application.

Mailing Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Provide the address where you can receive official correspondence, if needed.

Academic Program or Major*

Enter the academic program or major you are completing at SUNY Niagara.

Expected Graduation Term*

Select the semester in which you expect to complete your degree or certificate.

Your SUNY Niagara Experience

Tell us how you have been involved at SUNY Niagara and in the surrounding community. Focus on the experiences that have been most meaningful to you. You do not need to include every activity. Highlight the experiences that best demonstrate your involvement, leadership, service, and impact.

Campus Involvement*

Describe your involvement in SUNY Niagara clubs, organizations, athletics, honor societies, campus programs, employment, leadership roles, or other activities. For each experience, consider including: The name of the organization, program, team, or activity, Your position or level of involvement, How long you participated, Your responsibilities, and/or Any accomplishments or contributions you made.

Leadership Experience*

Share an experience in which you provided leadership, took initiative, supported others, solved a problem, or helped a group reach a goal. Leadership does not require holding an official title. You may discuss leadership demonstrated in a classroom, club, workplace, team, service project, or personal experience.

Community Service and Volunteer Experience

Describe any community service, volunteer work, civic engagement, advocacy, fundraising, mentoring, or other efforts you have participated in. Include the organization or community served, your role, and the impact of your involvement. If you have not participated in formal community service, you may leave this field blank.

Employment, Family, or Personal Responsibilities

You may use this space to describe employment, caregiving, military service, family responsibilities, or personal circumstances that have shaped your college experience or demonstrate your commitment, perseverance, and growth. Only share information you are comfortable including.

Achievements and Impact

This section gives you an opportunity to highlight your academic accomplishments, personal growth, and contributions to SUNY Niagara. The committee is interested in both what you accomplished and how your experiences have affected others.

Academic Achievements*

Describe the academic accomplishments you are most proud of from your time at SUNY Niagara. Examples may include: Academic honors or awards, Dean’s List recognition, research or creative projects, presentations or publications, academic competitions, honor society membership, internships or field experiences,, certifications or specialized training, significant academic improvement, and/or challenges you worked to overcome. There is no minimum GPA requirement for the President’s Medallion Award.

What accomplishment or experience from your time at SUNY Niagara are you most proud of, and why?*

Tell us about one accomplishment, contribution, or experience that was especially meaningful to you. Explain what you did, why it mattered, and what you learned from the experience.

How have you made a positive impact on the SUNY Niagara community?*

Describe how your involvement, leadership, service, academic work, or interactions with others have contributed to the student experience or the broader campus community. Whenever possible, include specific examples.

How have you grown during your time at SUNY Niagara?*

Reflect on how your SUNY Niagara experience has influenced your confidence, goals, values, leadership, relationships, academic development, or future plans.

Additional Information

Share anything else you would like the President’s Medallion Selection Committee to consider when reviewing your application. You may use this space to provide context about an accomplishment, explain a circumstance that affected your college experience, or highlight something not addressed elsewhere in the application. Please do not repeat information already included in another section unless additional explanation would be helpful.

Commencement Student Speaker Acknowledgment*

The recipient of the President’s Medallion may be invited to serve as the student speaker at SUNY Niagara’s Commencement ceremony. The selected student will receive guidance and public speaking support while preparing their remarks. Please indicate your understanding and availability.

Yes, I understand and would be willing to serve as the Commencement student speaker if selected.

I may be willing to serve but would like additional information.

I am unable to serve as the Commencement student speaker.

Please Tell Us More*

Briefly explain any questions, scheduling concerns, or circumstances related to serving as the Commencement student speaker.

Supporting Materials

Supporting documents are optional unless otherwise indicated. Upload only materials that provide helpful information not already included in your application. You do not need to submit a separate cover letter unless you believe it will strengthen your application.

Resume

Drop files here or

Accepted file types: pdf, doc, docx, Max. file size: 5 MB.

Upload a current resume highlighting your education, campus involvement, employment, community service, leadership, awards, and other accomplishments.

Letter of Support or Recommendation

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Accepted file types: pdf, doc, docx, Max. file size: 100 MB.

You may upload one or more letters from faculty, staff, employers, community leaders, coaches, advisors, or others who can speak about your accomplishments and character. Letters are optional and should provide additional information that is not already included in your nomination or application.

Additional Supporting Document

Drop files here or

Accepted file types: pdf, doc, docx, jpg, jpeg, png, Max. file size: 100 MB.

Upload an optional document that helps demonstrate your academic achievement, leadership, service, creativity, campus involvement, or other accomplishments. Examples may include an award certificate, project summary, publication, portfolio sample, or cover letter. Please do not upload sensitive personal, financial, or medical records.

Review Your Application

You’re almost finished! Before submitting, review your responses for accuracy and make sure your uploaded documents open correctly.

Electronic Signature*

Type your full legal name below. By entering your name, you are electronically signing this application and confirming your agreement with the statements above.

Date*

President’s Medallion Supplemental Student Application

About You

Your SUNY Niagara Experience

Achievements and Impact

Supporting Materials

Review Your Application