Alumni Awards Nominee Information Form

Alumni Awards Nominee Information Form

Please indicate the appropriate award for your nomination.




Nominator's Information

First Name:

Last Name:

E-mail:

Nominee's Information

First Name:

Last Name:

E-mail:

Address:

City:

State:

Zip Code:

Home Phone:

Business Phone:

Business Name:

Business Address:

Business City:

Business State:

Business Zip Code:

Current Position:

Date of Birth:

Nominee's Hometown/High School:

NMU Degree(s) (include year, type, major):

Other Degree(s) (include year, type, major, name of degree-granting institution):

List significant data to support nomination (include occupational information; attach documentation):

Honors Received, Leadership Roles, Community Service, etc: