Alumnus of The Year - Nomination

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Alumnus of the Year

Alumnus of the Year - Nomination

Nomination Form
As an LSUSD alumnus, a student, faculty, staff member or friend, you are encouraged to nominate someone to receive the Alumnus of the Year award!

Alumnus of the Year Award
This award was established in 1998. The criteria are: distinguished professional achievement, distinguished leadership, service to the LSU Health Sciences Center School of Dentistry (LSUSD), service to the community and loyalty to the ideals of LSUSD. This award remains the school’s premier alumni honor.

How to Nominate
Submit a brief essay stating why your nominee should receive the Alumnus of the Year award. Be as specific as possible; include anecdotal stories, examples of excellence and descriptions of achievements. All nominations are confidential and are reviewed by the LSUSD Alumni Association Board of Directors. Deadline for this year's nomination is Monday, August 16.

Information to Include
In addition to the information about your nominee, please include your name, address and contact information.

How to Submit a Nomination

Submit Online below or

Mail the nomination to:
LSUHSC School of Dentistry
1100 Florida Ave., Box 143
Attn: Joanne Courville
New Orleans, LA 70119

Nominee
Alumnus of the Year Award Honorary Alumnus of the Year Award (for non-alumni friends of LSUSD)
Name
Class Year
Address
City
State
Zip
Country
Telephone
Fax
E-mail

Is this nominee aware of your nomination? Yes No

Why this nominee deserves the Alumnus of the Year Award:

Nomination Submitted By
Name
Class Year
Address
City
State
Zip
Country
Telephone
Fax
E-mail

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Last Update 8/2009