Mildred Clodfelter Alumni Award

Nomination Form

Thank you for your nomination. To complete this process, please fill out the form below and mail or fax a letter addressed to the Mildred Clodfelter Award Selection Committee that details your nominee's qualifications.

Mail:
Attn: Mildred Clodfelter Selection Committee
KU Alumni Association
1266 Oread Avenue
Lawrence, KS 66045-3169

Fax:
785-864-5397

Please provide the following information.

*= Required Field

Nominee Information
Name *
Address *
City *
State/ Province/ Region
ZIP Code/ Postal Code (If applicable)
Country
KU Class/Year
Membership in the KU Alumni Association (required): (Annual/Life/Jayhawk Society)
Please describe how the nominee has "sustained volunteer service to the University at the local level".*

Past Service (Include dates when known)
Alumni Association:
Board of Directors
Committees
Chapter Leadership
Kansas Honors Program Leadership
'Hawk to 'Hawk Mentor
Student Recruitment
Jayhawks for Higher Education
Endacott Society
Other events or special programs

Other University Organizations:
Endowment Association
Athletics Corporation
Chancellor's Office
School & College
Office of Admissions and Scholarships

Additional Information:
Previous honors
Please list Web sites or other sources of additional information and attach newspaper clippings or other documentation available.

Nominator Information
Nominated by *
Address
Phone
E-mail *
Date
Miscellaneous Comments

Your nomination will be forwarded to the selection committee after your letter is received.