Alumni Awards/Athletic Hall of Fame Inductees
Nomination Form
Mail to: Millikin University,
Attention: Jan Devore, Director of Alumni Relations, 1184 W. Main Street, Decatur, Illinois 62522.
The deadline is Friday, April 18, 2008.
(Once nominated, a candidate for an award remains on the nomination ballot for three years.)
REQUIRED: ATTACH TO THIS NOMINATION FORM WRITTEN
DOCUMENTATION WITH PERTINENT INFORMATION IN SUPPORT
OF YOUR CANDIDATE'S NOMINATION.
I nominate_______________________________ Class
Year______
(Be sure to include maiden name, if applicable.)
Address _______________________________________________
City _____________________________ State _____ Zip ________
Phone (home) ___________________ (work) __________________
Occupation _____________________________________________
Nomination for
___________________________________________
Nominator ________________________ If alum, Class
Year ______
(Be sure to include maiden name, if applicable.)
Relationship to Nominee __________________________________
Address _______________________________________________
City _____________________________ State _____ Zip ________
Phone (home) ____________________ (work) _________________
E-mail address __________________________________________
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