NOMINATION FORM - College of Business International Alumni Award for Achievement


Please visit the following website for a complete list of requirements and elgiblity citeria:
http://www.business.uiuc.edu/alumni/awards/iaa/nomination.html


Please mail, fax or e-mail the completed nomination form to:

External and Alumni Affairs
College of Business
University of Illinois at Urbana-Champaign
470K Wohlers Hall, MC-706
1206 S. Sixth Street
Champaign, IL 61820
USA
 
Fax - (217) 333-4254
Email - alumniaffairs@business.uiuc.edu


(*An asterisk denotes a required field; we ask that all fields be answered where possible.)


NOMINEE INFORMATION

Name of person you are nominating*:
Current employer or institutional affiliation*:
Title:
Country of residence*:
Country of origin*:
Programs attended at the University of Illinois:


NOMINATOR INFORMATION

Principal nominator name (your name)*:
Current employer or institutional affiliation*:
Country of residence*:
Phone number*:
Email address*:
Brief summary of nominee’s qualities, achievements and work that are relevant to the award criteria (approximately 300-500 words):


ADDITIONAL REFERENCES

If possible, please provide contact information for 1-2 references (in addition to yourself) that will support this nomination:

Reference #1

Full Name:
Current employer or institutional affiliation:
Title:
Country of residence:
Phone number:
Email address:
Relationship to nominee:


Reference #2

Full Name:
Current employer or institutional affiliation:
Title:
Country of residence:
Phone number:
Email address:
Relationship to nominee:

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