Honorary Alumni Award Nomination Form

The Honorary Alumni Award is given by the Penn State Schuylkill Alumni Society to honor people who are not graduates of Penn State University but have made significant contributions towards its welfare, reputation, or prestige. The award is given only when the Alumni Society wishes to honor an exceptional person.

Download the nomination form.

Nominee's Personal Information

Name

Email Address

Phone

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Nominee's Professional Information

Profession/Occupation

Job Title

Company/Organization Affiliation

Additional Nominee Information

Penn State Activities and Memberships

Please list all current and former Penn State involvements.

Contributions: Civic and Volunteer

Please describe the nominee's activities and contributions that demonstrate a commitment to public service.

Penn State Schuylkill Involvement

Describe how the nominee has distinguished themselves specifically through their involvement with Penn State Schuylkill.

Nominator's Contact Information

Nominator's Name

Email Address

Phone Number

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

From a non-Penn State system-linked source, please attach a letter of support of designation for this nominee.

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Honorary Alumni Award Nomination Form

Alumni Organizations