Centurions Nomination Form for 2021

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Please use this application to nominate yourself or someone else for service on the Chancellor's Centurions.

Biographical Information
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Educational Background

Affiliations and volunteer engagement at UT institutions:
Please select all that apply.

*We request that members attend a minimum of one event per UT System fiscal year. Additionally, we require a minimum annual financial contribution of $500.00 from each member. Please reference the Chancellor's Centurions By-laws here.

We take your privacy seriously and will not use the information you provide for purposes other than those needed to contact you about participation on the Centurions and provide information and updates about our program.

Please contact Melissa Jackson with any questions you may have about joining the Chancellor’s Centurions.

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