Ole Miss Alumni Award Nominations - COPY

Award Nomination Form

Nominations must be submitted by April 1st.

Please Choose Award Type Below:

-Nominee Information-

Nominee's Name*

First Name

Last Name

Nominee's Email Address

Nominee's Phone Number

Nominee's Address

Address Line 1

Address Line 2

City

State

ZIP Code

Nominee's Class Year

Nominee's Field of Achievement

Additional Information About Nominee

Please upload any supporting documents. It is essential that the person submitting the nominations provide all materials pertinent to the nominee. The selection committee will do no further research.

No File Chosen

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Accepted file types: jpg,jpeg,gif,png,bmp,tif,psd,pdf,doc,docx,xls,xlsx,txt,mp3,mp4,aac,wav,au,wmv,avi,mpg,mpeg,zip,gz,tgz,tar

-Information About You-

Submitted by:

Name

First Name

Last Name

Phone

If you would like to encourage others to send letters of recommendation in support your nominee, they may be mailed to:
Ole Miss Alumni Association

Attn: Kirk Purdom/Alumni Award Nomination

P.O. Box1374
University, MS 38677

or email Kirk Purdom at kirk@olemiss.edu