MSU Billings Alumni Relations

Outstanding Alumni Awards

MSU Billings Outstanding Alumni Nomination Form

The Montana State University Billings Alumni Association's Outstanding Alumni Awards Program recognizes
MSU Billings Alumni who have made exceptional contributions to society, their professions, and the University.

This form is for your convenience, as you supply information about your nominee, and will be submitted to
the Alumni Awards Selection Committee for their review.

No member of the Outstanding Alumni Awards Selection Committee may make a nomination.
Self nominations are accepted.

Please provide Nominee's information:

First Name  
Last Name  
Organization
Street Address  
Address (cont.)
City
State/Province
Zip/Postal Code  
Country
Work Phone  
Home Phone  
FAX
E-mail    

Please provide Nominator's information:
First Name  
Last Name  
Organization
Street Address  
Address (cont.)
City
State/Province
Zip/Postal Code  
Country
Work Phone  
Home Phone  
FAX
E-mail    

Please list three references (individual or business), including name, address, email address and telephone, who could provide additional information on your nominee.
 

Please list examples of personal, professional, civic contributions, and a special service such as, but not limited to: The Montana State University Foundation, Alumni Association, mentoring, career networking, leadership on boards and committees, guest lecturer:

How has the nominee exhibited unusual courage, creativity, perseverance, originality of competency in their chosen field; raised the quality of life for other; contributed to and promoted the advancement of higher education; or distinguished themselves as leaders in their profession or area of interest?

List examples of major awards, honors, commendations and other distinctions of achievement.

Please provide other information that you feel will be helpful to the committee as it considers this nominee.
 

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