DISTINGUISHED ALUMNUS NOMINATION FORM

The Distinguished Alumnus Award, first awarded in 1970, recognizes and honors West Texas A&M University graduates who have made significant contributions to society and whose accomplishments and careers have brought credit to WTAMU. The following criteria should be considered when nominating an individual for the Distinguished Alumnus Award:

1. The nominee holds a degree (or degrees) from West Texas A&M University.
2. The nominee should be successful in his/her profession.
3. The nominee should be easily identified with West Texas A&M University.
4. The nominee should have contributed to West Texas A&M University in the form of volunteer service and general support of University programs.
5. The nominee should have contributed to the area in which he/she lives, to his/her profession or to fellow humans.

THE GENERAL PUBLIC IS INVITED TO SUBMIT NOMINATIONS.

The recipient(s) is honored at the WTAMU Alumni Association's Phoenix Banquet held annually on the first Saturday in May.

Nominee First Name

Nominee Middle Name

Nominee Last Name

Address

City

State   Alabama Alaska American Samoa Arizona Arkansas California Canal Zone Colorado Connecticut Delaware Washington D.C. Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Virgin Islands Washington West Virginia Wisconsin Wyoming

Zip

Home Phone

Work Phone

Name of Business

WT Degree(s)

WT Graduation Year

REASON FOR NOMINATION