Name *

First Name

Last Name

Phone *

(###)

###

####

Select the Award this nomination supports. *

Golden Alumni Lifetime Achievement Award: This award will be presented to a seasoned SUAF-WDC Chapter Member who has made meaningful contributions to the chapter, Southern University, their profession, and the broader community through the years.

Young Professional Alumni Award: This award will be presented to a SUAF-WDC Chapter Member under 40 years old, who has made meaningful contributions to the chapter, Southern University, their profession, and the broader community.

Distinguished Alumni Leadership Award: This award will be presented to a SUAF-WDC Chapter Member who has served the chapter in a leadership capacity and made meaningful contributions to the vitality of the chapter.

Distinguished Alumni Citizen Award: This award will be presented to a SUAF-WDC Chapter Member who has exhibited generosity with their time, talent, and/or treasure to the SUAF-WDC Chapter, Southern University Alumni Federation, Southern University System, and/or other local, national, or global organizations, initiatives, and/or causes.

Distinguished Alumni Career Award: This award will be presented to a SUAF-WDC Chapter Member who has made significant contributions and achievements in their chosen profession that is worthy of commendation.

Exemplary Service to the Chapter Award: This award will be presented to a non-SUAF-WDC Chapter Member who has been an exceptional supporter of our chapter through the years. The awardee does not have to be a graduate of Southern University.

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####