Indicates required field Candidate's full name: Candidate's full name: Candidate's date of birth, if known: Candidate's date of birth, if known: Candidate's present position: Candidate's present position: Candidate's address and zip code: Address Address Address 2 Address 2 City/Town City/Town State/Province State/Province - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon ZIP/Postal Code ZIP/Postal Code Reason for awarding the degree: Reason for awarding the degree: Candidate's degrees, institution, and date earned: Candidate's degrees, institution, and date earned: Has this candidate received any additional degrees? Has this candidate received any additional degrees? - Select -Yes No If so, please list them here, along with the names of the respective institutions and the dates that the degrees were earned. If so, please list them here, along with the names of the respective institutions and the dates that the degrees were earned. Has this candidate received any previous honors? Has this candidate received any previous honors? - Select -Yes No If so, please list them here, along with the name of the organization(s) presenting the award: If so, please list them here, along with the name of the organization(s) presenting the award: Candidate is being suggested as: Candidate is being suggested as: - Select -Commencement speaker Honorary degree recipient Suggested honorary degree to be awarded: Suggested honorary degree to be awarded: - Select -Arts Engineering Humane Letters Laws Science Nominator's full name: Nominator's full name: Nominator's title: Nominator's title: Nominator's full address, including city, state, and zip code: Address Address Address 2 Address 2 City/Town City/Town State/Province State/Province - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon ZIP/Postal Code ZIP/Postal Code Nominator's phone number, including area code: Nominator's phone number, including area code: Is this candidate being nominated by more than one individual? Is this candidate being nominated by more than one individual? - Select -Yes No If so, please list all additional nominators here, along with their respective titles, addresses, and phone numbers: If so, please list all additional nominators here, along with their respective titles, addresses, and phone numbers: Do you wish to include any additional relevant information about this candidate? Do you wish to include any additional relevant information about this candidate? - Select -Yes No If so, please feel free to attach the files here: If so, please feel free to attach the files here: One file only.Allowed types: gif jpg jpeg png bmp eps tif pict psd txt rtf html odf pdf doc docx ppt pptx xls xlsx xml avi mov mp3 mp4 ogg wav bz2 dmg gz jar rar sit svg tar zip.5 MB limit per file. The accumulated size of all files in this form cannot exceed 25 MB. Leave this field blank Leave this field blank