Wimba Hall of Fame Nomination Form
Primary Contact
*Name:
*Title:
*Institution or School Affiliation:
*Mailing Address:
*Phone Number:
*Email Address:
Team Contact Information
In the case of team nominations please provide the contact information of up to three team members.
Team Member #1
Name:
Title:
Institution or School Affiliation (unless same as above):
Mailing Address:
Phone Number:
Email Address:
Team Member #2
Name:
Title:
Institution or School Affiliation (unless same as above):
Mailing Address:
Phone Number:
Email Address:
Team Member #3
Name:
Title:
Institution or School Affiliation (unless same as above):
Mailing Address:
Phone Number:
Email Address:
Wimba Products Used (Check all that apply):
Wimba Classroom
Wimba Pronto
Wimba Voice
Wimba Create
Diploma
Description of collaboration scenario (minimum 250 words):
Impact of collaboration scenario (please be as quantitative as possible - minimum 250 words):
If you would like to submit additional materials or documents, please email them to
halloffame@wimba.com
.