Alumni Awards: Call for Nominations

Alumni Awards Nomination Form
Award Categories
Distinguished
alumni who are exceptionally accomplished in their fieldEarly Career Achievement
alumni who received their first degree in their field in the last 20 yearsHonorary
non-graduates who have made a difference at KU Medical Center
Health ProfessionsMedicineNursing
Health ProfessionsMedicineNursing
Health ProfessionsMedicineNursing
Nominee's Information

You may leave non-required fields blank. The Office of Alumni Relations will help you compile the remaining contact information.
Full Name*

First NameLast Name
Current title/position*
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail
example@example.com
Home Phone
Format: (000) 000-0000.
Degree
Class Year
Nominator's Information
Full Name*

First NameLast Name
Current title/position*
Business
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
example@example.com
Home Phone
Format: (000) 000-0000.
Yes, I have the required documents to submit my nomination.No, please follow up with me about submitting the required documents to finalize my nomination.
Supporting Documents
Nominee's current curriculum vitae

Cancelof
Letter of Recommendation #1

Cancelof
Letter of Recommendation #2

Cancelof
Additional File #1 (not required)

Cancelof
Additional File #2 (not required)

Cancelof
All additional materials are attached and nomination is complete.Additional materials will be sent via fax, email or mail.
YesNo
Should be Empty:

Alumni Awards Nomination Form

Award Categories

Nominee's Information

Nominator's Information

Supporting Documents