Distinguished Alumni Form

NOTICE: Form will time out after a few minutes! To avoid loss of work, please draft your responses in another program and paste into the form.

Step 1: Nominee/Nominator Information Step 2: Award Questionnaire

* Required Fields

Nominee's Information

First Name*

Maiden Name

Last Name*

Street Address

City

State

Zip

Telephone

Grad. Year

Major

Nominator's Information

First Name*

Maiden Name

Last Name*

Street Address

City

State

Zip

Telephone

Grad. Year

Major

For which award would you like to nominate your friend or classmate?

Advancement in Career:

This award recognizes alumni who focused their lives on improving their career field; have made a significant impact on their profession, and have improved society through their chosen careers.

Outstanding Service to the Community:

This award recognizes alumni that have dedicated their lives to serving the needs of others through volunteer activities, helping those less fortunate form physical, emotional, medical or psychological concerns, or working to improve society through civic organizations or governmental committees.

Dedication to the University:

This award recognizes alumni who have been moved to give back to the institution that provided the base for their successful lives. These leaders have participated in programs such as service learning, Cooperative Education/Career Development, hosted student teachers, physical therapy students, physician assistant students, scholarship fundraisers, acted as class agents, or contributed to the student life at Daemen University.

Distinguished Alumni Award:

This Premier award recognizes a graduate who has achieved distinction in all three of the above categories.

Graduate of the Last Decade:

This award recognizes a graduate from the last decade who falls into one of the above categories selected by the committee and nominated by a member of the Daemen University community (alum, faculty, staff and administration). Please designate your nominee as a Graduate of the Last Decade and outline their Outstanding Commitment to the University, the community, or achievement in their career.

Advancement in Career Outstanding Service to the Community Dedication to the University

Distinguished Alumni Award

Graduate of the Last Decade (Gold) -

Advancement in Career Questionnaire

1. Nominee's Type of Employment: 2. Positions achieved in this employment and others: 3. How have the nominee's achievements positively made an impact on society?

Graduate of the Last Decade (Gold) -

Outstanding Service to the Community Questionnaire

1. List the volunteer activities, civic/government organizations or committees of the nominee and note how long has the nominee been involved in these activities: 2. How have the nominee's volunteer activities directly serviced the needs of others?

Graduate of the Last Decade (Gold) -

Dedication to the University Questionnaire

1. What specific university program has the nominee participated in since graduation and note how long has the nominee been involved in these activities? 2. How have the nominee's activities directly impacted the university?