Canisius College - Award Nomination Form

Alumni Award Nomination Form

Please complete the sections of this form that correspond to the award for which you are nominating someone. Then click the Submit button at the bottom of the page. The form will then be sent to the Office of Alumni Relations. Incomplete forms will not be accepted.

Submitted by:
Date:
Street Address:
City:
State:
Zip Code:
Phone:
E-Mail:

Name of Nominee:
Class Year

For the DiGamma Society nomination, describe in detail the nominee's accomplishments as they pertain to his/her chosen career. Please include their Professional Title.

For the Distinguished Alumni nomination, describe in detail the nominee's accomplishments as they pertain to his/her chosen career. Please include their Professional Title.

Years at Canisius College:
For the Distinguished Faculty nomination, describe in detail the nominee's contributions to the academic world and how he/she exemplifies teaching excellence.

Major:
GPA:
For the Distinguished Senior nomination, describe in detail the nominee's leadership roles and involvement with Canisius College.

For the LaSalle Medal nomination, describe in detail the nominee's contributions to Canisius College.

For the Peter Canisius Medal nomination, describe in detail the nominee's contributions to the educational, spiritual, social, cultural and intellectual advancement of mankind.

Sports played:
Years played Varsity Sport:
Positions Played:
For the Sports Hall of Fame nomination, describe in detail the nominee's athletic history and any outstanding athletic achievements. Describe how the nominee's life continues to reflect favorably on the College.

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Alumni Award Nomination Form

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Alumni & Friends

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Alumni Award Nomination Form

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