Skip to content Group menu sidebar Home 50th Anniversary Hub About Strategic Plan Annual Awards Burian Lecture Series Clinical Education Diversity, Equity and Inclusion Facilities Anatomage Table Simulation and Skills Lab Study Hub Interprofessional Education SUPPORT Academics Majors Career Pathways Continuing Education CE Course Proposal Experience-Driven Learning Registered Student Organizations Study Abroad Transfer students Advising Alumni Advisory Board Alumni Academy Nominate an Outstanding Alum Alumni Updates Financial Aid Giving Research Scholarships Student Services Unified Clinics Center for Disability Services Technology Resources Directory CHHS IT Student Services Contact Us Distinguished Alumni Nomination Form Use the form below to nominate an individual for induction into the CHHS Distinguished Alumni Academy. Your Name (required) Your Role (required) Faculty (current or past) Alum CHHS Community Other Other Role: Your Email (required) Nominee Name (required) Nominee Email We'll need a way to get in touch with your nominee if selected. Nominee Department (required) - Select -Blindness and Low Vision StudiesBronson School of NursingGerontologyHealth AdministrationIntegrative Holistic Health and WellnessInterdisciplinary Health Sciences, Ph.D.Healthcare Services and Sciences -or - Interdisciplinary Health ServicesOccupational TherapyPhysician AssistantPhysical TherapySocial WorkSpecialty Program in Alcohol and Drug AddictionSpeech Pathology and Audiology Nominee Graduation Year (required) Why should your nominee be inducted? More information Upload If you have more information you would like to include, you may attach a file here.One file only.2 MB limit.Allowed types: txt pdf doc docx ppt xlsx. Submit Leave this field blank
