Alumni Award Nomination

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:

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
3307 3rd Ave. W., Suite 303
Seattle Pacific University
Seattle, WA 98119