Distinguished Alumni Award Nominations

Please fill out the below form to nominate. Note that the more information, the better. The boxes do expand if more room is needed for the content.

Distinguished Alumni Award

Nomination Form

Date of Nomination in MM/DD/YY*

Nominating anonymously?*

Nominator First Name*

Nominator Last Name*

Nominator's UCM Affinity

Alumni/ Former Student

Faculty/ Staff

Friend of UCM

No Affinity to UCM

If Alumnus, Class Year(s)

Nominator Phone Number*

Nominator Email*

Click to view help for this field.

Nominator Street Address*

Nominator City*

Nominator State*

Nominator Zip Code*

Please select the award you are nominating an individual for:

Distinguished Alumni

Distinguished International Alumni

Distinguished Alumni for Service

Distinguished Alumni for Early Achievement

Nominee First Name*

Nominee Last Name*

Nominee Class Year(s) if known

Nominee Phone Number*

Nominee Email*

Nominee Street Address

Nominee City

Nominee State

Nominee Zip Code

Please share a bit about your relationship to the nominee.*

Please describe how the nominee is distinguished in his/ her chosen career field.*

Optional: Provide web links to supporting materials, such as nominee's LinkedIn profile, professional recognition, publications, etc...

Please note that nominations remain on file for consideration for four years. The Alumni Foundation Board of Directors, Engagement committee reviews all candidates, select the top nominations, and votes on the Distinguished Alumni honorees. Therefore, the award is highly competitive and all nominations are not guaranteed an award.

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University of Central Missouri Alumni Foundation
PO Box 800, Smiser Alumni Center
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Phone: 660-543-8000 | alumni@ucmo.edu

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