Alumni Association Awards Nomination Form
We invite you to submit nominations for Fort Hays State
University alumni and friends in one or more categories by reviewing
the award criteria and selecting the appropriate award. Please complete
the nomination form below to submit biographical information on your
nominee. Please include as much detailed information as possible and
use a separate form for each nomination. Also, please include
three letters of reference on your nominee sent by mail to the FHSU
Alumni Association at the address listed below. Letters should
be from individuals who can attest to the qualifications necessary to
receive the corresponding award. Nominations are limited to 10 pages,
not including reference letters.
Nominations are confidential and individuals will not be notified of
their nomination by the Alumni Association. The nominator is responsible
for documenting the nominee’s qualifications as outlined by the
selection criteria. This nomination form and the requested reference
letters are the only source of information for the selection committee
and are vital to the committee in making an informed decision.
The FHSU Alumni Board of Directors Awards and Recognition Committee
reserves the right to consider the nominee for any appropriate award.
Current FHSU Alumni Board of Directors and staff are not eligible
for consideration. Deadline: February 27, 2009.
Click here for a printable version of this form.
Choose one of the following. See the descriptions below to help you
make your choice.
Please enter the name of the award for which you are nominating
this person:
Alumni Achievement Award - honors graduates who have made outstanding
and unselfish contributions in service to their community, state,
or nation as citizens, in chosen career fields, or through philanthropic
work.
Distinguished Service Award - recognizes an individual or individuals
not graduates but known as a friend of the university. The honor
is reserved for those who have demonstrated a continuing concern
for humanity on a universal, national, state, or community level;
who support spiritual, cultural, and educational objectives; and
who endorse and exemplify the highest standards of character and
personal attributes.
Nita M. Landrum Award - recognizes alumni or friends who have provided
sustained volunteer service for the betterment of the Alumni Association
and/or FHSU, especially in their home communities or at any local
level.
Young Alumni Award - designed to recognize those early in their
career who have had outstanding achievements and recent accomplishments.
The award is based upon professional and educational achievements,
community activities, honors and awards received and other noteworthy
items of merit since graduation. Candidates must hold a bachelor's
degree from FHSU, be members of the 10-15 year reunion classes,
and be under age 40 as of Jan. 1 of the year the awards are presented.
PLEASE NOTE: This form contains several entry boxes for long blocks
of text. The Alumni Association recommends that nominators first
review the form, compose the text in a word processing document
and save it, and then copy and paste the contents into the form.
This will help ensure that elements of the nomination are not irretrievably
lost during the process, and it creates a copy of the nomination
for the nominator.
NOMINEE
Full Name
Maiden Name (if applicable)
FHSU Degree
Major(s)
Graduation Year(s)
Home Address
City, State, Zip
Telephone
E-mail address
Business Name
Business Address
Business Telephone
Title
Hometown
High School
Nominee's degrees from other colleges/universities:
Present Occupation:
State why the nominee deserves this award; list outstanding achievements
in chosen field of endeavor and evidence of local, national, or international
distinction:
Career since leaving Fort Hays State University:
Special recognitions, honors or awards:
Publications or patents:
Membership in organizations (professional, civic, philanthropic, etc.).
Please indicate offices held:
Outstanding qualities:
Campus Activities at FHSU:
Other information of interest:
NOMINATED BY
Name
E-mail address
Address
City, State, Zip
Telephone
Date of nomination
Please send three letters of reference to the address listed below:
Fort Hays State University
Alumni Association
One Tiger Place
Hays, KS 67601
Telephone: 785-628-3767
Toll Free: 1-888-351-3591
E-mail:
alumni@fhsu.edu
Fax: 785-628-4191
