Syracuse University

Nomination Form

Alumni Nominations- Be sure to indicate which award you are submitting the nomination for.

* = required

Award

*Nominee name:

*Nominee address (city, state, country):

*Academic Information:

Other Academic Honors or Degrees:

*Professional Organizations:

SU Alumni Organizations:

*Volunteer Activities:

*Statement:

*Nominator name:

*Nominator email:

*Nominator address:

*Nominator city:

*Nominator state:

*Nominator zip:

*Nominator phone: