Nomination Form

The priority deadline for Outstanding Young Alumni and Distinguished Alumni Award nominations is March 1 to ensure timely completion of the full process by March 15.

Please complete all required fields below.

Alumni Awards Nomination Form

Award for which you are nominating*
- Distinguished Alumni Award
- Outstanding Young Alumni
- Alumni Outstanding Service Award
Nominee's information
Please provide the information for the nominee.
Name*
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Email address*
Preferred daytime phone number*
Nomination information for Distinguished or Outstanding Young Alumni Award
Please describe in detail why you believe your nominee is worthy of a UWO alumni award. Also, provide information about any professional or service-related achievements that support this nomination.
Nomination Information for Alumni Outstanding Service Award
Please describe in detail why you believe your nominee is worthy of the UWO Alumni Outstanding Service Award. Also provide information about support of the University via volunteer efforts, energy, leadership, service-related activities and/or monetary donations.
Nominators name*
First Last
Nominator's information
Please provide your information in this section
Relationship to nominee
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Email address of Nominator*
Preferred daytime phone number*
Alternative phone number

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Nomination Form

Alumni Awards Nomination Form

Nominee's information

Nominator's information