Nomination Form

Your award nomination may be submitted with our online nomination form below, or you may also download our Award Nomination Form and submit your nomination via US mail. Please save the pdf file ro your computer before filling it out. You may email the pdf file to Jane Algermissen at jalgermissen@unm.edu, or you may mail to:

The University of New Mexico Alumni Association
1 University of New Mexico
MSC 01 - 1160
Albuquerque, NM 87131-0001
ATTN: Awards Nomination Form

Award Information

Chose the Award Select OneZia AwardLobo Award-------Erna S. FergussonFaculty TeachingBernard S. RodeyJames F. ZimmermanCitizenship AwardAluminaria

Date NominatedJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember 12345678910111213141516171819202122232425262728293031 201020112012

Nominee's Information

First Name

Middle Name

Last Name

Address

City

StateSelect OneAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonDistrict of ColumbiaWest VirginiaWisconsinWyoming

Zip

Telephone

Email

About the Nominee

Is the nominee an alum of UNM? Select OneYesNoNot Sure

Professional Position / Role

Please decribe the contributions / accomplishments of the nominee:

Additional Information: Please provide further information about the nominee that you think would be helpful.

Nominator's Information

Name (First/Last)

Address

City

State/ProvinceSelect OneAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonDistrict of ColumbiaWest VirginiaWisconsinWyoming

Telephone

Email Address** **Check box to receive a copy of nomiation

What UNM College/School/Department are you from (if applicable)?

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Privacy: The UNM Alumni Association respects your privacy. Your email address will not be shared or sold to a third-party.