Alumni - Outstanding Alumni Awards Nomination

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Office of Alumni Affairs
800 GSW State University Drive
Americus, GA 31709-4379
alumni@gsw.edu
229.928.1373
toll free: 866.673.0436

Outstanding Alumni Awards Nomination

Please complete the form below to nominate a Georgia Southwestern State University alumna/alumnus. Only completed nominations received by the due date will be considered.

Note: We strongly recommend completing your answers in another word processing application and then copying and pasting your responses below to have a record of your nomination, and to avoid any chance of losing your work. Click here for more information about each award.

Award:

Aeolian Award

Visionary Award

Young Alumni Award

Family Legacy Award (Please nominate a FAMILY, not an individual)

Nominee Information

Nominee's Name or Family Name:

Nominee's Title:

Nominee's Degree or Program (if applicable):

Graduating Year:

Nominee's Email Address:

Nominee's Phone Number:

Nominee's Postal Address:

City

State

Zip

Nominee's family connection to GSW (required for Family Legacy Award)

Nominator Information

Your Name:

Your Title:

Your Relationship to Nominee:

Your Email Address:

Your Phone Number:

Your Postal Address:

City:

State:

Zip

Please describe your nominee’s exceptional professional achievements and contributions or service, as they relate to the award criteria.

Please describe the impact of your nominee on a local, regional, national, and/or international level.

What other attributes has your nominee demonstrated to support this nomination?

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