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Alumni Awards of Merit 2023 Nomination Form
Notes for Nominators:
All letters of support are confidential and will be viewed only by members of the Selection Committee.
It is recommended that the nomination remain confidential and not shared with the nominee.
Posthumous nominations will not be accepted.
Bullet points are preferred.
We look forward to receiving your nomination.
Nominee Information
Name of Nominee
Degree and Year of Graduation (if known)
Address
City
Country
Postal Code
Email
Current Telephone Number
This Nominee is being submitted for:
Dr. Ivan Smith Award
Community Service Award
Professional Achievement Award
Young Alumni Award
Nominator Information
Name
Address
City
Country
Postal Code
Email
Current Telephone Number
Relationship to Nominee
1. Reasons for nominating this candidate as related to the awards criteria. (3500 character limit)
2. Business, industry or community awards and honours received (850 character limit)
3. Community service and volunteer activities (850 character limit)
4. Please include any other information about the candidate that might assist the Selection Committee. (850 character limit)
4. Please attach letters of support. Three maximum.
5. Attach any documents pertinent to the nomination. Although not required, CV’s can be helpful for the Selection Committee.
Please submit the full nomination package by Wednesday, March 1, 2023.
Late submissions will not be accepted.
Direct any questions about the awards to
takinai@uwo.ca
nonprofit software