Loyal Service Award Nomination Form

Peter Akers Award Nomination Form
Please fill out the form to nominate an individual for the McKendree Alumni Association Peter Akers Award. This is the McKendree Alumni Association’s most prestigious honor. Each year it is presented to a distinguished alumna or alumnus who has had remarkable success in his or her profession, whose life reflects the values of McKendree University, and who has demonstrated unparalleled loyalty to the University.
Name*

First NameMiddle NameLast NameSuffix
Email
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Phone
Nominee Name (include maiden name if applicable)
Nominee McK Class Year
McKendree Degree
Nominee Email
example@example.com
Nominee Phone
Nominee Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Degree(s) from institutions other than McKendree
Occupation
Business Title
Attach Nominee's CV/Resume (optional)

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Attach Letter of Support (optional)

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Professional Involvement
Special Honors & Recognition
McKendree Related Activities
List examples of other community involvement
How does the nominee's work and/or accomplishments reflect the value of his/her McKendree education?
What significant achievements has the nominee made in his/her profession?
Why should this individual be considered for the McKendree Loyal Service Award?
Nominator's McKendree Affiliation and/or Relation to Nominee?
Do we have permission to contact you with further questions regarding your nomination?

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Lebanon, Illinois 62254

(618) 537-4441

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Peter Akers Award Nomination Form