Duke University Chapel Humanitarian Service Award Application

To submit an application, fill out the form below by November 13, 2020. Applications can also be made by postal mail or email.

Postal Mail:
Rev. Breana van Velzen
Duke University Chapel
Box 90974
Durham, NC 27708

Email: breana.van.velzen@duke.edu

1. Name and contact information of Candidate/Nominee:
2. Explain candidate's/nominee's relationship to Duke:
3. Describe history of service, emphasizing service in the Durham community if applicable:
(1500 words max)
4. Share intended use of grant:
(750 words max)
5. References for Candidate/Nominee:

Please list contact information for three individuals who know the Candidate/Nominee and could be contacted to provide a reference. If you are nominating someone other than yourself, please include your contact information as the first of these references. Please include email addresses and phone numbers.

6. Provide Any Further Written Recommendation for Nominee