Outstanding Alumni Award Nomination Form

Name of Nominee:

Organization Affiliation of Nominee:

Semester of Graduation of Nominee:

Name of Individual Making the Nomination:

Phone Number:

Email:

Local Address:

Selection Criteria:

1. Service to organization
2. Participation in organization events
3. Assistance provided to members
4. Impact on students

Please use the space below to form a detailed explanation as to how your nominee’s involvement has influenced your organization and presently enrolled students along with any other information you would like to share in 250 words or less.

If you have any supporting documents, please send them as a PDF to campusawards@uww.edu. Please include the award and your name in the subject line.

Please submit and return all award materials no later than 4:00 pm on Friday, April 2, 2010.