Nomination Form

Faculty of Agriculture

Nomination Form

Award Nominee Name

Award Nominee Profession

Place of employment (or if retired, most recent)

Position

Nominee Email

Nominator Name

Nominator Profession

Nominator Place of employment (or if retired, most recent)

Relationship to Nominee

Nominator Email

Nominator Phone

Rational

Describe the reason for your nomination (if more space is required, email colette.wyllie@dal.ca)

Impact

Elaborate on the impact of your nominee’s accomplishments (ex: created change, created stability, improved lives)?

Captcha

Please note

By submitting this nomination, you understand the award selection committee many contact you with follow-up questions.
Nominations will be considered valid for a three-year-period.
You do not need to be an alumnus to submit a nomination. 聽

Suggested documents 鈥� If possible, email the following documents to colette.wyllie@dal.ca聽to assist the selection committee by expanding on the nominee鈥檚 story and character:

Resume
Personal anecdotes
Reference letters

Questions?

colette.wyllie@dal.ca
902-893-6022

Suggested supplementary documents can be emailed or mailed to:

pilipili漫画, Agricultural Campus
Office of Advancement
Colette Wyllie
PO Box 550
Truro, NS
B2N 5E3

Thank you for participating in the celebration of Dalhousie鈥檚 outstanding alumni! 聽聽聽聽聽聽聽聽