Fillable Nomination Form 2016 Distinguished V2 - Nomination Form_2016_Distinguished_v2

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Nomination Form 2016 Distinguished V2 - Nomination Form_2016_Distinguished_v2

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Top Dog Alumni Awards
Nomination Form
Please send this nomination to the Fresno State Alumni Association, 2625 E Matoian Way SH124, Fresno, CA 93740 or
via facsimile at 559.278.6790 by Monday, February 15, 2016 at 4:00 PM (for the 2015 awards gala). For additional
information, please call 559.278.ALUM.
Distinguished Alumni Award
The Distinguished Alumni Award is the highest honor given to an alumnus/alumna of the
university. The university president and the Fresno State Alumni Association present the award.
The award is based on scholarship, leadership and service to the university, the San Joaquin
Valley, the State of California and beyond. It has been established to provide special recognition
to an individual who has distinguished them self through outstanding achievement during their
post-collegiate career.
Administration of the Award
• Nominees shall have completed 30 units of coursework at Fresno State.
• Nominees will have made a significant contribution to Fresno State, the San Joaquin
Valley and/or the State of California.
• Nominees must have received national or international recognition.
• The recipient or a family member must be able to attend the awards ceremony.
• The Top Dog Alumni Awards Selection Committee may nominate an existing nominee
from the Outstanding Alumni Award from any school or division to be a part of the
Distinguished Alumni Award pool for consideration for the Distinguished Alumni
Award. Such nomination will take place during the course of business of the Award
Selection Committee meeting.
*Please note that current Fresno State employees must be nominated for reasons outside of
their actual job description.
**All nominations will be reviewed for completion. Incomplete nominations will be sent
back to the nominator for resubmission. Attachments may not be used in lieu of answering
nomination questions.
Once nominated, alumni who do not receive the Distinguished Alumni Award will be considered
for an additional two years for the award. Once three years has expired, nominations must be
updated and resubmitted. Additional material such as updated biographical information may be
added to the nominee’s file within the three year time span for future years’ review.
The Alumni Award Selection Committee will meet and review all nominations. The Committee
shall have the discretion to accept or reject any of the candidates in each area. The Executive
Director of the Fresno State Alumni Association will notify the winners of the awards.
The alumnus/alumna who receives the Distinguished Alumni Award will be honored at an
awards gala hosted by the Fresno State Alumni Association. The recipient will also be hosted in
the President’s skybox during a home football game, and will be invited by the president of the
university to return to campus to share their expertise with students, faculty and administrators.
Top Dog Alumni Awards
Nomination Form
Please send this nomination to the Fresno State Alumni Association, 2625 E Matoian Way SH124, Fresno, CA 93740 or
via facsimile at 559.278.6790 by Monday, February 15, 2016 at 4:00 PM (for the 2015 awards gala). For additional
information, please call 559.278.ALUM.
Distinguished Alumni Award
Please Print
I am pleased to nominate:
First Name Middle Maiden Last Name
! School/College
! Student Affairs ! Athletics ! Library !Graduate Studies
Year of graduation
with a degree in
(if applicable)
This nominee can be contacted at:
Address:
City:
State:
Zip:
Home Phone:
Work Phone:
Email:
This nomination is made by:
Your Name:
Address:
City:
State:
Zip:
Home Phone:
Work Phone:
Email:
Your relationship to the nominee:
Your signature:
Date:
A press release may be sent to the awardee’s local news publication and/or trade journal:
Name of Local News Publication:
Contact Name:
Phone:
Contact Email:
Name of Trade Journal:
Contact Name:
Phone:
Contact Email:
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Top Dog Alumni Awards
Nomination Form
Please send this nomination to the Fresno State Alumni Association, 2625 E Matoian Way SH124, Fresno, CA 93740 or
via facsimile at 559.278.6790 by Monday, February 15, 2016 at 4:00 PM (for the 2015 awards gala). For additional
information, please call 559.278.ALUM.
Please outline how the nominee has accomplished outstanding achievement during his/her post-
collegiate career. Provide specific examples of project participation, award recognition,
management, development, and any relevant information. (REQUIRED)
Please detail how the nominee has provided significant contribution to Fresno State. Provide
specific examples of service including but not limited to volunteer service, faculty/staff interaction,
and student interaction. (REQUIRED)
Please detail how the nominee has provided significant contribution to the San Joaquin Valley.
Provide specific examples of involvement with community organizations, fundraising efforts, board
participation, and service. (REQUIRED)
Please detail how the nominee has provided significant contribution to California and beyond.
Provide specific examples of involvement with national organizations, fundraising efforts, and
service outside of the Valley. (REQUIRED)
Please describe how the nominee has received national or international recognition. Provide
specific examples of involvement with national/international organizations, collaboration efforts,
committee participation, and any relevant information. (REQUIRED)
Please attach a biographical sketch or professional resume and any letters of reference for the
nominee to this form (minimum 1 page, maximum 3 pages).
Attachments MAY NOT be used in lieu of answering nomination questions.
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Completed 3 May 2020

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