Ohio Wesleyan University | Alumni & Friends | Alumni Award Nomination Form

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Alumni Award Nomination Form

Recognizing alumni for outstanding service to Ohio Wesleyan University

Note: Fields marked with an asterisk (*) must be filled in prior to submitting this form.

Nominee's Information

*Full Name:

*Home Address:
(line 1)

Home Address:
(line 2)

*Home Telephone Number:
(+ area/country code)

Work Telephone Number:
(+ area/country code)

*Home e-mail Address:

Work e-mail Address:

*Occupation:

*OWU Class Year:

*Please describe the nature of the nominee's outstanding service(s) to the University:

*Other facts and comments about the nominee:

*How long have you known this person?

*In what capacity have you known this person?

Nominator's Information

*Full Name:

*Home Address:
(line 1)

Home Address:
(line 2)

*Home Telephone Number:
(+ area/country code)

Work Telephone Number:
(+ area/country code)

*Home e-mail Address:

Work e-mail Address:

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