Alumni - Valparaiso University

: Loke Hall
1100 Campus Drive South
Valparaiso University
Valparaiso, IN 46383
800.833.6792
219.464.5467 (fax)
alumni@valpo.edu

VUAA Alumni Award Nomination Form

If you prefer to mail in this nomination please print out this form, fill it out and mail to:

VUAA Committee on Awards
Loke Hall
Valparaiso University
1100 Campus Drive South
Valparaiso, IN 46383

My nominee for an alumni award is:

First Name:
Last Name:
Home Address:
City:
State:
Zip Code:
Day Phone:
E-mail:
VU Class Year or Years Attended:
Age:

Nominated by:

First Name:
Last Name:
Home Address:
City:
State:
Zip Code:
Day Phone:
E-mail:
Relationship to Nominee:

Please read the description of each award before making your recommendations. A candidate may be nominated for more than one award category. The selection committee reserves the right to grant an award for which the candidate has not been nominated. Please make sure that your statement of nomination clearly explains, in full, how your candidate fulfills the criteria contained in the award description.

Nomination

Please check one:
Distinguished Alumnus/Alumna Award
Alumni Achievement Award
Outstanding Young Alumnus/Alumna Award
Alumni Service Award
Partners In Service Award
Alumni Community Service Award
Honorary Alumni Membership

Statement of Nomination:

By checking this box I am acknowledging that I plan to e-mail or mail in my Statement of Nomination
(WARNING: By clicking here you will erase anything in the Statement of Nomination box upon submission.)

Additional references (optional):

List no more than two individuals who are writing letters in support of your candidate.

Reference:
Home Address:
City:
State:
Zip Code:
Day Phone:
E-mail:
Relationship to Nominee:
Reference:
Home Address:
City:
State:
Zip Code:
Day Phone:
E-mail:
Relationship to Nominee:

Additional comments and/or a resume may be submitted by mail to:

VUAA Committee on Awards
Loke Hall
Valparaiso University
1100 Campus Drive South
Valparaiso, IN 46383

Questions about the process? Call the Valparaiso University Office of Alumni Relations at 219.464.6942, fax 219.464.5467, or send an e-mail to vuaa.awards@valpo.edu.

Nomination Deadline: February 15