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Alumni Awards Nomination

 

Complete this form to nominate someone for one or more alumni awards. Please contact the UIU Alumni Office at 563-425-5388 with questions. 

 Completion of all fields is required.  If you don't want to provide an answer for a particular question, simply put "na" as the answer.  You cannot leave a field blank.

NOMINEE INFORMATION

First Name:

Last Name:

Maiden Name (if applicable):

Mailing Address:

City:

State:

ZIP:

Primary Phone Number:

E-mail address:

Verify E-mail Address:

UIU Class Year:

Provide a brief description of past or current UIU involvement: (50-word maximum)

I wish this nominee to be considered for an Alumni Award in the following category.
(Check at least one category. You may check more than one if more apply.)

Service to Community
Presented to an alumna/us who has provided service in society in such areas as education, religion, volunteerism and community organizations.  Give examples and years of service.

Emerging Alumni
The Emerging Alumni Award recognizes the service to the University, community service, or professional accomplishment of a recent Upper Iowa University graduate from any center or program.  Graduate must be within 10 years of graduation from UIU.

Professional Accomplishment
Presented to an alumna/us who has demonstrated exceptional achievements in a professional career.  Give examples, career, education and years in field.

Service to Country
Presented to an alumna/us who has demonstrated exceptional achievements in a professional career specifically related to their military service. Special consideration may be given to a candidate for exceptional commitment to their country as a civilian acting in support of military endeavors.

Service to Upper Iowa University
Presented to an alumna/us who has provided exceptional stewardship to the University or demonstrated the spirit of the mission of Upper Iowa University in stewardship and/or service in their environment.

Please provide a letter of recommendation as it relates to the award category(s) you've selected:(500-word maximum)

NOMINATED BY

First Name:

Last Name:

Maiden Name (if applicable):
 

Mailing Address:

City:

State:

ZIP:

Primary Phone Number:

E-mail address:

Verify E-mail Address:

UIU Class Year:

Provide a brief description of your relationship to the nominee: (50-word maximum)

 

 

If you need assistance with anything now or in the future, feel free to contact us at:

Upper Iowa University
Institutional Advancement & Alumni Development 
PO Box 1857
Fayette, IA 52142
Phone: 563-425-5238
Email: alumni@uiu.edu

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