NMSU branding
New Mexico State University
New Mexico State University

All About Discovery!

University Advancement

Select Date: / /
NOMINATOR INFORMATION  
   
Name: 
Daytime Phone: 
- - ext. (if applicable)
E-mail: 
Address Line 1
Address Line 2
(if applicable)
City/State/Zip: 
- include +4
  What hours are most convenient for you to be contacted?
  -
   
NOMINEE INFORMATION
   
Name: 
(First, Middle, Last)
Preferred First Name: 
Address Line 1
Address Line 2
(if applicable)
City/State/Zip: 
- include +4
Home Phone: 
- -
Cell Phone: 
- -
   
Business / Employer: 
Title / Position: 
Address Line 1
Address Line 2
(if applicable)
City/State/Zip: 
- include +4
   
Retired
- - (month-day-year)
Last Position: 
Last Employer: 
   
  STATEMENT of SUPPORT
  Describe why you are nominating this person and what distinguishes him or
her to receive this honor. Consider the following points as a guide to describe how the nominee exemplifies the ideals of New Mexico State University: Mission and goal fit; academic excellence; achievements that merit this honor; community and public service; personal and moral integrity; and recognition of peers.
 
   
  If you prefer to list biographical information, the following area is provided for your convenience. You may also list any additional information and/or email a current vitae or resume.
   
  EDUCATION
   
Institution: 
Institution: 
Degree/Certificate: 
Degree/Certificate: 
Year: 
Year: 
   
Institution: 
Degree/Certificate: 
Year: 
   
Institution: 
Degree/Certificate: 
Year: 
   
  PROFESSIONAL LICENSES and CERTIFICATIONS
   
 
Authorizing Organization /
Professional Board
Designation
(CPA, Pilot, etc.)
   
  SERVICE ON BOARDS OF DIRECTORS
(Corporate, Foundation, Community, Civic, etc.)
 
   
Organization Position (Member, Officer, Trustee, etc.)
   
  AWARDS / RECOGNITIONS / HONORS
   
 
Awarding Organization Title of Recognition Year
   
  MILITARY SERVICE
   
 
Branch of Service Rank Years
   
  FAMILY
   
 
Name Relationship   Name Relationship
 
 
 
 
   
Questions/Comments: 
   

Before clicking submit, please review the numbers and address information
entered. Your privacy is our top concern. None of your information will be sold
or provided for solicitation.

 
Enter Confirmation Code:

Thank You for your nomination! Please allow for a twenty-four hour processing time (forty-eight hours if sent on the weekend).