Distinguished
Service Award
Tufts University Alumni Association
Nomination Form
Nominations are
due by November 16, 2007. Please print and mail to: Attn: Jessica Johnson Sherwood,
80 George Street, Suite 100-3, Medford, MA 02155 or fax to Jessica
at 617-627-3938. For more information, please contact Jessica at j.johnson@tufts.edu
or 617-627-5786 or 1-800-843-2586.
I am pleased to nominate _____________________________________________________________
to receive the Tufts University Alumni Association Award for Distinguished
Service to:
___ the University ___ his/her profession ____his/her community
School and Year of nominee: __________________________________________________________
Nominee's home address and telephone number: _______________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Occupation and title: ________________________________________________________________
Company's name: __________________________________________________________________
Business address and tel. number: ____________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
Community Involvement: ____________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
Why is this person worthy of a Distinguished Service Award? (Please include
a separate page
or pages addressing this question; a c.v. is very helpful to the Awards
Committee.)
Your name, address, and telephone number: ___________________________________________
________________________________________________________________________________
________________________________________________________________________________
Your relation to nominee: ___________________________________________________________
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