Physics Distinguished Alumni Award Nomination Form
Please make sure to fill out all required fields. For questions or comments, contact Carole Cuaresma at
ccuaresm@umd.edu
.
* Required
First, please identify yourself:
*
(Title, First Name, Last Name)
Nominators contact information:
*
Please include your contact information in case we need to discuss your nomination. (Phone number and E-mail)
Who would you wish to nominate for the Physics Distinguished Alumni Award?
*
(Title, First Name, Last Name)
Nominee's Degree Information:
Please provide degrees held and years obtained.
Nominee's contact information:
*
Please provide as much contact information that you can.
Please state why you think the nominee should be honored with the Distinguished Alumni Award.
*
Additional information can be sent to Carole Cuaresma at ccuarem@umd.edu