Alumni Awards Nomination Form

We accept and appreciate nominations for the Distinguished Alumnus and Humanitarian awards. Submit your nomination below:

Nominations will be accepted through November 30, 2023

Items marked with * are required.

* Choose an award for this nomination:

Distinguished Alumnus Award

Established in 1984, the Distinguished Alumna/Alumnus Award recognizes a graduate whose exceptional professional achievements, contributions to one’s chosen field, and service to the School of Nursing have brought honor to the individual and to the University of Rochester.

Humanitarian Award

Established in 2013, the Humanitarian Award honors a graduate whose work as a practitioner, administrator, volunteer, or researcher has had a profound impact on those most in need.

Nominee Information

* Name:

* School of Nursing Degree and Graduation Year:

Mailing Address:

Phone Number:

Email:

Reasons for Nomination

* Please describe in detail why this nominee is deserving of the award selected. What do you consider the nominee's most important achievements? This can include professional accomplishments, service to the community, dedication to the School of Nursing, commitment to the underprivileged or underrepresented, and more.

If you prefer, this information may be submitted as a separate letter. Letters can be attached to this form or sent separately via email or mailing address—both listed at the end of the nomination form.

Additional Education

Advanced Degree or Training:

Year:

Name of Institution:

Present Profession

Employer:

Occupation:

Title:

Nominator Information

* Name:

If applicable, School of Nursing and Graduation Year:

Mailing Address:

Phone Number:

* Email:

Your connection to the nominee:

Supporting Documents

In addition to completing the above form, the nominating process appreciates the following additional materials—including supportive articles or documents written by or about the nominee that will help inform the School of Nursing of the candidate's qualifications:

Curriculum Vitae of nominee: Summarized into a maximum of two pages. (If providing award information, please only submit the number awarded)

Letter of Support:

Items marked with * are required.

Nominating materials can be emailed to sonalumni@admin.rochester.edu or mailed to:

URMC Academic Programs
School of Nursing Office of Alumni Relations
Alumni Awards Program
Larry and Cindy Bloch Alumni and Advancement Center
300 E. River Road, P.O. Box 278996
Rochester, New York 14627-8996

It is understood that the information presented on this form will be treated confidentially in its use by the School of Nursing Office of Alumni Relations and that any decision made by the School will be final.