Calendar: Deadline for nominations is Sept. 30. The Campus Alumni Advisory Board will select up to 12 recipients per year, per campus. The awards will be presented by the University of Illinois Alumni Association.

Send nominations to:

University of Illinois Alumni Association
Alice Campbell Alumni Center
601 S. Lincoln Ave., MC-077
Urbana, IL 61801
Fax: 217/333-7803
E-mail: alumni@uillinois.edu

PLEASE NOTE: This form contains several entry boxes for long blocks of text. The Alumni Association recommends that nominators first review the form, then compose the text in a word processing document and save it, and then copy and paste the contents into the form. This will help ensure that elements of the nomination are not irretrievably lost during the process, and it creates a copy of the nomination for the nominator.

If you experience any difficulties with this online form, please contact the Alumni Association at 217/333-1471, or fax the nomination to 217/333-7803, or send e-mail to alumni@uillinois.edu.
You also can use the MS Word version:

INFORMATION ABOUT THE NOMINEE:

Nominee is a graduate of the following campus (Select one.):

PLEASE SELECT ONE Urbana-Champaign Chicago Springfield

Full name (Include name at graduation in parentheses, if different.):

Home street address:

City:

University of Illinois degree(s) received:

Class year:

College/School/Department/Major:

Nominee's degrees from other colleges/universities:

Present occupation (Include title and company, profession, business address, etc.; if retired, date of retirement.):

State why the nominee deserves this award, and outline nominee's significant contributions benefitting the University of Illinois Alumni Association and/or affiliated organizations - alumni clubs, constituent associations, UI Foundation, athletics, college, school or department:

Special recognitions, honors or awards:

Contributions toward the advancement of education and the University of Illinois:

Nominee's family - name of spouse and children - indicate if any attended/are attending the University of Illinois and degrees (This information is optional.):

Nominated by:

Your address:

Phone number:

FAX number:

Your e-mail address (Necessary in order to process this form.):

 
 
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