Alumni and Friends - University of the Incarnate Word

Alumni Association Board of Directors Nomination Form

* Fields labeled in red require an entry.

Nominator Your name:
Street Address:
City, State, Zip:
Daytime telephone number:
Evening telephone number:
Email address:

Nominee Name:
Street Address:
City, State, Zip:
Daytime telephone number:
Evening telephone number:
Email address:
Year of graduation: Degree:

Educational Background other than Incarnate Word Institution: Degree: Year:
Institution: Degree: Year:

Occupational History (list more current position first) Employer Position: Dates:
Employer Position: Dates:

Awards, Honors, and Recognition (regional, national, and international)

Involvement with University of the Incarnate Word since graduation

UIW ACCOMPLISHMENTS Please provide a detailed account of the nominee's achievements while at Incarnate Word. List such items as academic honors and organization involvement on campus.

COMMUNITY SERVICE Please provide a detailed account of all involvement in community service-related activities. This should include the names of organizations and any special recognition received while involved with these groups.

IN SUMMARY Please provide any additional information about this nominee not covered in the categories above. It is appropriate to add an endorsement statement in behalf of the nominee.

I hereby nominate the individual as named. As the nominator I certify, to the best of my ability, that the information I am providing is accurate. Furthermore, I believe that if selected, the individual whom I have nominated is willing to serve.