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UW Oshkosh Alumni Award Nomination Form

Nomination form for Outstanding Young Alumni and Distinguished Alumni

Please submit all materials electronically.

Your E-Mail Address (Required)

Award for which you are nominating (please check)

Distinguished Alumni Award
Outstanding Young Alumni Award

NOMINATOR's full name (Required)

Relationship to Nominee (Required)

NOMINATOR's Business Mailing Address

Place of Employment

Street

City

State

Zip

NOMINATOR's Home Mailing Address

Street

City

State

Zip

Home E-mail (Required)

Preferred daytime phone number with area code (Required)

Alternate phone number with area code

NOMINEE's full name (Required)

NOMINEE's Business Mailing Address

Place of Employment

Title

Street

City

State

Zip

Business E-mail

Business phone number (Required)

NOMINEE'S Home Mailing Address

Street

City

State

Zip

Preferred E-mail (Required)

Preferred daytime phone number with area code (Required)

Degree(s) earned (If known)

List degree(s) and year(s) the nominee received from the University of Wisconsin Oshkosh

Other degree(s) (If known)

List any degrees awarded by non-UW Oshkosh educational institutions.

Reason for nomination (Required)

Resume or vita (Required)

Support Letter 1 (Required)

Support Letter 2 (Required)

Support Letter 3 (Required)

Additional Support

Award nominations are due March 28.

Upcoming Events: Valentine's Theatre Date Night Various,
Feb 16, 2012; 2012 Women's Basketball Alumni Day Various,
Feb 18, 2012; Russ Young Leadership and Achievement Award Banquet Hilton Garden Inn of Oshkosh,
Feb 18, 2012; Planting the Seeds of Inclusion Conference UWO campus,
Mar 03, 2012; UWO Alumni Free Day at the Oshkosh Museum Oshkosh Public Museum,
Mar 03, 2012; Previous events; Upcoming events…

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UW Oshkosh Alumni Award Nomination Form