Alumni Awards Nomination Form Please enable JavaScript in your browser to complete this form.Your Name *FirstLastYour Phone Number *Your Email Address *I nominate the person listed below for the: *Distinguished Alumni Award – Outstanding career achievement and service of the highest order to their communityOutstanding Alumni Service Award – Outstanding service and dedication to Methodist University Alumni AssociationOutstanding Faculty/Staff Award – Demonstrated a high level of accomplishment within his/her official duties to Methodist UniversityDistinguished Young Alumni Award – Must have graduated within the last 10 years. Outstanding voluntary or other public service on a local, state, national or global level. This should include service to Methodist University and participation in other clubs, service organizations, MUAA activities, or community involvement within the last 10 yearsNominee InformationName *FirstLastMaiden NameGraduation Year *Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEmailWork PhoneHome PhoneEmployment HistoryPlease list the nominee’s present or most current employment first. Please check the box to add additional employment information.EmployerTitleDatesSpecific accomplishments, honors, awards while in this positionDo you have more employment history to enter?YesNoEmployerTitleDatesSpecific accomplishments, honors, awards while in this positionDo you have more employment history to enter?YesNoEmployerTitleDatesSpecific accomplishments, honors, awards while in this positionEducation HistoryPlease list all college/universities attended, including Methodist University and any graduate or post-graduate institutions. Please check the box to add additional employment information.College or UniversityYears AttendedMajor(s)Degree Earned and DateDo you have more education history to enter?YesNoCollege or UniversityYears AttendedMajor(s)Degree Earned and DateDo you have more education history to enter?YesNoCollege or UniversityYears AttendedMajor(s)Degree Earned and DatePARTICIPATION IN ACTIVITIES, HONORS RECEIVED, ACCOMPLISHMENTS WHILE AT METHODIST UNIVERSITYCOMMUNITY ACTIVITIES, SERVICE, HONORS, ETC., AFTER ATTENDING METHODIST UNIVERSITY PROFESSIONAL ACTIVITIES, SERVICE, HONORS PUBLICATIONS (If the nominee has had books, articles, etc., published, please list here.) FAMILY (Please list, if any, spouse and children. Also indicate any family members who have attended or are attending Methodist University.) SERVICE TO METHODIST UNIVERSITY (As an alumnus/a, please list any volunteer work, giving history, board membership, etc.) OTHER INFORMATION (Please list anything you feel is important in the committee’s consideration of this nomination.) CommentSubmit Share Tweet Messenger Pinterest Share reddit Email