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Athabasca University

Alumni Awards Nomination Form

Nomination Deadline: March 11th, 2016

Please indicate the award for which you are nominating a candidate:




Nominator Information







(evening/weekend)

Nominee Information




Code



(evening/weekend)


Please provide as much information as possible. Suggested length 1000 words.




The personal information collected on this form will be used for the purposes of administering an Athabasca University Alumni Award. This personal information is collected under the authority of Section 33(c) of Alberta’sFreedom of Information and Protection of Privacy Act. If you have any questions about the collection and use of this information, please contact Athabasca University Alumni Relations.

Updated February 01 2016 by Web Services - Advancement

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