Alumni Award Nomination

___ Alumnus of the Year ____ Medallion Award ____Distinguished Leadership or Service

Information about your nominee:
Name of Nominee _______________________________________________________
Last, First, Middle

Academic College _______________________________________________________

Degree__________________ Major ___________________ Year _________________

Other Degrees ___________ Year _________ University ________________________

Address________________________________________________________________
Street, City, State, Zip

Telephone (_____)_______________ (_____)_____________ (____)_______________
Daytime, Evening, Fax

______________________________
E-mail

Professional Achievements:

Civic or Professional Organizations:

Biographical Data and Resume must accompany this form. Provide a liberal amount of information and include support materials with this form. The Awards Committee will use your information in the deliberation process. Please provide accurate and substantial information. Nominator and nominee may be contacted for additional information.

____________________________________________ (_____)______________
Signature of Nominator, Telephone

___________________________ __________
E-mail, Date

Check One: Alumnus Faculty /Staff Friend Former Student

_________________________________________________________________
Printed Name of Nominator

_________________________________________________________________
Address

_________________________________________________________________
Street, City, State, Zip

Please print this form and send it to:

Alumni Association Awards
Alumni Center
Seattle Pacific University
Seattle, WA 98119