Hall of Fame Nomination Form

SIUE Alumni Hall of Fame
Nomination Form

Nominee Name:______

Nominee Address:______

Nominee City, State, Zip:______

SIUE Grad Year:______Major:______

Home Phone:______Cell Phone:______

Email:______

Employer:______Title:______

Work Address:______

City, State, Zip:______

Work Phone:______Email:______

Please describe accomplishments and successes achieved by the nominee in his/her chosen field of study:

Please describe the positive impact by the honoree in his/her chosen field of study:

Please list any awards and/or recognition the honoree has received:

Please list the honoree’s community involvement and activities:

Please describe any civic awareness and concern the nominee has demonstrated:

Please describe any involvement the honoree has had with SIUE following graduation:

Please describe any support of higher education the nominee has given following graduation:

Nominee Name:______

Nominee Address:______

Nominee City, State, Zip:______

SIUE Grad Year:______Major:______

Home Phone:______Cell Phone:______

Email:______

Signature:______Date:______

Nominations are due by Friday, July 25, 2008.

To nominate yourself or another alumnus/a, please complete the form and mail to:

SIUE Alumni Association

Attention: Hall of Fame

Campus Box 1031

Edwardsville, IL 62026-1031

Or fax to: 618-650-3964