Alumni award nomination form

I wish to nominate:

Name:

UW-Eau Claire degree:

Additional and/or advanced degrees and institutions attended:

Current street address:

City, state, ZIP:

Employer:

Current occupation:

Award for which you are nominating this individual (see award descriptions):






Please explain why you feel this individual should receive an award:

What is your nominee's life-guiding philosophy and/or greatest strengths?

Submitted by:

Name:

Street address:

City, state, ZIP:

Daytime phone:

e-mail address:

Thank you for completing our alumni award nomination form.