Chicago Illini of the Year

Nomination Form

Calendar: Deadline for nominations is Sept. 30.

A selection committee composed of UI Alumni Association staff and Chicago Illini Club board members will select the recipients. The awards will be presented at the Chicago Illini of the Year Awards Dinner in Chicago.

Send nominations to:

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

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: More


INFORMATION ABOUT THE NOMINEE:

Nominee is a graduate of the following campus:



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

Home street address:

City:

State:

Zip code:

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; list outstanding achievements in chosen field of endeavor and evidence of national or international distinction:

Career since leaving the University:

Special recognitions, honors or awards:

Publications or patents:

Civic activities, philanthropic endeavors:

Other information of interest:

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

INFORMATION ABOUT THE NOMINATOR

Nominated by:

Your address:

Phone number:

FAX number:

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