UNIVERSITY OF WYOMING
DISTINGUISHED ALUMNI AWARD
NOMINATION FORM
UNIVERSITY OF WYOMING D I S TIN GUISHED ALUMNI NOMINATION
University of Wyoming
Distinguished Alumni Nomination Form
The University of Wyoming Distinguished Alumni Awards are given to people who meet the
following qualifications:
1. Must be distinguished in his or her business, profession, career or life work.
2. Must be a person of such integrity, stature and demonstrated ability that the University
faculty, staff, students and alumni will take pride in his or her recognition.
3. Must reflect and realize the importance of the education received at the University of
Wyoming.
4. Must be a person who has attended the University of Wyoming.
People in the following categories are not eligible to receive the award:
1. Anyone who is a candidate for public office at the time of selection.
2. Any current member of the selection committee, UW Alumni Association Board of Directors,
or UW Board of Trustees.
3. Any person who cannot be present to accept the award.
If you know anyone you think should be considered for this honor, please complete this form
and return it by February of each year to the Alumni Association, Marian H. Rochelle Gateway
Center, 222 S. 22
nd
St., Laramie, WY 82070 Attn. Marisa Reilly. The form is also available on the
association’s website: http://www.uwyo.edu/alumni/about-the-uwaa/da-msa/.
In addition to completing the information required in the nomination form, nominators should
also submit letters of support for the nominee. No more than ten letters of support are
recommended.
UN IVERSITY OF WYOMING D I S T I N G UISHE D ALUMNI NOMIN A TION
Date ________________________
Name of person nominated _________________________________________________
Address _________________________________________________________________
City, state, zip ____________________________________________________________
Home Phone ( ) Work Phone ( ) __________________________
Type of Business __________________________________________________________
Present position and title __________________________________________________
Approximate years he/she attended the University of Wyoming ___________________
What significant contributions has he/she made in his/her field?
What honors has he/she received in connection with his/her career?
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UN IVERSITY OF WYOMING D I S T I N G UISHE D ALUMNI NOMIN A TION
Please give a brief biography of the nominee's career history. (If more space is needed, please
use the back of this sheet.)
In what civic or philanthropic activities has he/she been involved?
Has the nominee given of time or service to the University of Wyoming? If so, please describe.
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UN IVERSITY OF WYOMING D I S T I N G UISHE D ALUMNI NOMIN A TION
If at all possible, please provide information about nominee concerning: family data, degrees
obtained, other universities attended, articles or books authored, hobbies, etc. (If more space
is needed, please use the back of this sheet.)
Name of person submitting nomination _______________________________________
Address _________________________________________________________________
City, state, zip ____________________________________________________________
Home Phone ( ) Work Phone ( ) __________________________
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