Award Nomination Form

The Distinguished Alumni Award is established to honor and recognize Fond du Lac campus alumni who have attained notable achievement in their career field, demonstrated philanthropic or public service activity in support of the community or provided inspiration to others.

The recipient will also be honored with a personalized brick in the Foundation Celebration Walk and have their name engraved on a perpetual plaque displayed in the University Center Commons.   Nominees must have attended the Fond du Lac campus at any time since the campus opened in 1968 for at least two semesters. Current Foundation Board members and Fond du Lac campus faculty and staff are not eligible to receive the award.

Please use the online nomination form below or fill out, print and mail the printable nomination form.

If you have questions, please contact the Foundation for the Fond du Lac campus at uwofdlfoundation@uwosh.edu or (920) 929-1335.

Distinguished Alumni Nominee Name*
First Last
Nominee Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Home Phone
Business Phone
Business/Organization Affiliation
Business Title
Dates Attended UW-Fond du Lac (if known)
Describe those activities, achievements or contributions made by the nominee which qualify him or her for the award:*
Nomination Submitted By:
Your Name*
First Last
Your Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Daytime Phone*
Your Email Address
(For confirmation purposes only)
Additional Comments
Have you received the nominee's permission to submit their name for this award?*
- Yes
- No

University of Wisconsin Oshkosh
Fond du Lac Campus
400 University Dr
Fond du Lac, WI 54935
(920) 929-1100

University of Wisconsin Oshkosh

OSHKOSH | FOND DU LAC | FOX CITIES

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Fond du Lac Campus

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Award Nomination Form

Nomination Submitted By: