Distinguished Service Award Official Nomination Form

The Distinguished Service Award Official Nomination Form

Comments

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Name of Nominee

First Middle Last Suffix

Maiden Name of Nominee (if applicable)

Nominee's Phone Number(Required)

Nominee's Email Address(Required)

Nominee's Current Residential Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Name of Nominee's Current Place of Employment

Nominee's Present Occupation

Nominee's Current Place of Employment Address

Street Address Address Line 2 City State ZIP Code

Full name of nominee's spouse/partner and any Clemson graduation years if applicable

Please list any of the nominee's immediate family members who graduated from Clemson with their full names, graduation years and relation to the nominee.

List Nominee's degree(s) and year(s) of graduation from Clemson, Year(s) attended Clemson, if not a graduate:

List any additional degree(s) the nominee received from other colleges (with graduation years):

Please provide a description of the impact this nominee has had on the mission of the Clemson Alumni Association. Examples could include service to a Clemson Club or affiliate group, Clemson Alumni Association Board of Directors, local alumni engagement efforts, etc.

If the nominee has served the CU Foundation through time, talent or treasure, please describe the impact they had on the initiatives of this board and the university through their service.

If the nominee has supported the IPTAY through time, talent or treasure, please describe the impact they had on the initiatives of this board and the university through their service.

Other Clemson Service/Involvement/Memberships and Offices Held

Describe specific significant contributions by nominee, benefiting Clemson colleges, departments, institutes, programs, and initiatives outside of those listed above. i.e. Board of Visitors, Student Affairs, etc.

Other Service/Involvement Civic Accomplishments/Memberships and Offices Held

Describe specific significant contributions by nominee, benefiting the community, state and nation, through public service, civic activities, social services, and membership in civic, social, and other community service organizations.

Professional/Personal Accomplishments

Please describe in detail any personal accomplishments of the nominee that should be taken into consideration by the committee. (Please include homemaker or professional volunteer accomplishments).

Former Occupations

Please describe in detail the nominee’s professional career and any accolades they received that should be taken into consideration by the committee. (Please include long-term careers, virtual or temporary work, homemaker or professional volunteer roles).

Please share the significant accomplishments and/or contributions by this nominee in their chosen career field.

List any of the nominee's memberships in professional or business related organization(s):

Full name of nominator and Clemson graduation year(s):(Required)

Nominator phone number:(Required)

Nominator email address:(Required)

Nominator mailing address:(Required)

Street Address Address Line 2 City State ZIP Code

Names of additional nominators and their Clemson graduation years:

Supporting Materials*(Required)

*Three letters of support are required for consideration, one being authored by the submitting nominator. If readily available, the nominee's resume may be included as supporting documentation. The nomination packet cannot exceed ten pages in length, including these required documents. By Signing "I Agree" below, you confirm that this nomination includes the required letters and addresses the three award criteria: dedication and service to Clemson University, personal and professional accomplishments, and devotion to one’s community and public service.

Max. file size: 50 MB.

Supporting Files(Required)

Max. file size: 50 MB.

Supporting Files(Required)

Max. file size: 50 MB.

Additional Supporting Files

Max. file size: 50 MB.

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