2010 ALUMNI AWARDS - Cal Aggie Alumni Association - UC Davis

2010 CAAA alumni Awards nomination form
No m i n e e f o r (check o n l y o n e):
Jerry W. Fielder Memorial
Emil M. Mrak International Award
Young Alumnus(a) Award
Distinguished Achievement Award
Outstanding Alumnus(a) Award
Aggie Service Award
Full Name
Class Year(s), Degree(s),
Mailing Address
E-mail
Telephone
(work)
(fax)
Professional Position
No m i n a t i o n submitted by:
Name
Mailing
E-mail
Telephone (home)
(work)
(fax)
Are y o u a b l e to attend t h e Aw a r d s Ceremony o n Sa t u r d a y, Ja n u a r y 30, 2010
Yes
No
Ea c h c o n f i d e n t i a l n o m i n a t i o n requires c o m p l e t i o n o f t h i s f o r m a n d t h e Letter o f
Suppor t l o c a t e d o n t h e reverse. Yo u m u s t a l s o i n c l u d e a r é s u m é.
Pl e a s e see a t t a c h e d checklist f o r a d d i t i o n a l i n f o r m a t i o n.
Selection of recipients will be based on submitted materials only.
Pl e a s e return completed f o r m a n d supporting d o c u m e n t s by Fr i d ay, Au g u s t 14, 2009 to:
Alumni Awards
Cal Aggie Alumni Association
University of California, Davis
One Shields Avenue
Davis, CA 95616-8517
You may also submit your nomination materials via fax at (530) 752-3395 or
online at www.alumni.ucdavis.edu/awards.