University of Montevallo - Alumni & Friends

ALUMNI & FRIENDS

Alumni Awards Nomination Form

NOMINATION CATEGORY*:

Distinguished Alumnus Award Alumnus Loyalty Award

Nathalie Molton Gibbons Alumni Achievement Award Nathalie Molton Gibbons Young Achiever's Award

NOMINEE:


Last Name*	First*	Maiden

Home Address:


Street or PO Box	City	State	Zip Code

Home Phone:	E-mail:

i.e.(205) 777-9999

Occupation:	Place of Business:

UM Class Year:

Other Institution(s) Attended/ Degree(s) Earned:

Honors/Achievements:

NOMINATOR:


Last Name*	First*	Maiden

Home Address:


Street or PO Box	City	State	Zip Code

Home Phone:	*E-mail:**

i.e. (205) 777-9999

Nominator’s standing*:

Alumna/Alumnus

Faculty/Staff

Student

Other

In what capacity have you known the nominee?

Please answer the following questions based upon the nomination category:
Distinguished Alumnus Award:
Describe, in general terms, the nominee's professional career?

Explain how the nominee has excelled in his/her career?

Alumnus Loyalty Award:
Describe how the nominee has demonstrated hi/her loyalty and dedication to UM.

Nathalie Molton Gibbons Alumni Achievement Award and Nathalie Molton Gibbons Young Achiever's Award:
Describe how the nominee's contribution, through his/her career or community service, has reflected positively on society.

Additional Comments:

Note: Those submitting nominations using this web form should also send supporting documentation to: University of Montevallo Alumni Awards Committee, University of Montevallo, Station 6215, Montevallo, AL 35115-6000.

*Indicates required fields.