Engaged Alumni Excellence Award Nomination Form

Nomination forms and supporting information must be received by Wednesday, February 15, 2013.

Please read the terms of reference carefully before submitting your nomination form.

Please note that only the 750 word summary of achievements and up to three letters of support will be considered in the selection process.  No other materials will be accepted.

For questions, please contact us.

* Letters of support should either be faxed to Student Relations Committee at (306) 966-5571 or e-mailed to alumni.office@usask.ca

Fields marked with are required.

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Printable Form

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Nominee Information

Date of Nomination

Day

Month

Year

Nominee Name Information

Nominee Degree Information

Nominee Address Information

Nominee Email Address and Phone Number

Phone Number

This is a mobile phone numberNoYes

Your Information

Name Information

Degree Information

Address Information

Email Address and Phone Number

Phone Number

This is a mobile phone numberNoYes

Nomination Information

Summary of Achievements

In 750 words or less, tell us why you believe that this nominee should be chosen to receive an Engaged Alumni Excellence Award.

Letters of Support

Please provide information about who has provided letters of support for this nomination.

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