distinguished alumni awards...

Champaign Urbana Schools Foundation

DISTINGUISHED

ALUMNI

AWARDS

PROGRAM

NOMINATION FORM 2018

Champaign Urbana Schools Foundation Distinguished Alumni Nomination Form Updated March 22, 2017

Unit 4 and District 116 Distinguished Alumni Awards Program The Purpose of the Awards

The Distinguished Alumni Awards shall recognize graduates of the Unit 4 and District 116 High Schools, including Champaign Centennial High School, Champaign Central High School and Urbana High School, whose achievements, strength of character, and citizenship serve as models to inspire and challenge today’s youth.

Conditions of Eligibility

The Distinguished Alumni Awards shall be open each year to any alumnus or alumna who graduated from the Unit 4 and District 116 High Schools no less than ten (10) years prior to that nomination year. Awards will be given for the achievement in various fields of service which may include athletics, business, education, entertainment, law, medicine, the military, philanthropy, politics, public service, religion, scholarship, science and the visual and performing arts.

The award must be accepted in person. If the alum is unable to attend the recognition event, the

Selection Committee may select a replacement, and the original nominee will be added back into the pool of candidates for a subsequent year.

No current member of the Selection Committee may be eligible for an award.

Nomination Procedure

Any person other than a member of the Selection Committee may submit nominations for the award.

Submission of the completed nomination form provided by the Selection Committee is required. The form must be typed or clearly written (it is available on the CUSF Website) and should be accompanied with a cover letter and a photo of the candidate.

Nominations may begin on the day following the most recent recognition event and continued until the announced deadline for the close of new nominations. Nominations received after the announced deadline will be considered candidates for the next recognition event.

All nomination information will be considered confidential by the Selection Committee. Selection Procedure

A Selection Committee shall receive and review all nominations and select award designees. The committee may request additional supportive documentation from a nominator. Additional letters of recommendation are not required but recommended.

No more than one (1) Distinguished Alum from each high school may be presented in any single year.

The Selection Committee reserves the right to reject any or all nominations.

Individuals nominated for the Distinguished Alumni Award and are not chosen will continue to be eligible for two (2) years following the initial nomination process without re-nomination.

ALL Nomination Forms must be returned to:

CUSF, P.0. Box 1166, Champaign, IL 61824-1166 Or, send a PDF to [email protected]



CUSF Distinguished Alumni Awards Program

Personal Statement of Recommendation Please state in a nomination cover letter why you believe that the nominee should be considered for the Distinguished Alumni Award. Also, please attach a 3 x 5 black and white photo of the nominee if at all possible. Reminder: Nomination Forms must be received no later than January 12, 2018 to be considered for 2018. Nominator’s Name: Nominator’s Address: Nominator’s Telephone and Email:

Name of Nominee:

Home Address:

Telephone: Home: Work:

Nominee’s Website: Email:

Principal Business:

Mailing Address:

Date of Birth: Place of Birth:

Spouse’s Name: Maiden Name:

Children (names and ages):

Father’s name: Mother’s name:

Address: Telephone:

Nomination Deadline: January 12, 2018



Distinguished Alumni Awards Program Nominee Support Documentation

Education: Names of schools with dates of attendance, degrees received honorary degrees with names of schools and dates. Include military and/or civilian schools that last 3 months or longer where certification or degrees are conferred. NOTE: Graduation from Champaign High School, Urbana High School, Champaign Central High School or Champaign Centennial High School is a requirement of the Distinguished Alumni Award. The nominee shall have graduated more than 10 years before the nomination date. High School: __________________________________________________________________________________________ Year of Graduation from High School: ____________________________________________________________________ Career Summary: You may attach a vita or resume. Please include any military service.



Civic, Philanthropic, Religious, Fraternal and Political Activities: Include offices held and dates. Professional and/or Commercial Activities: Corporate directorships or similar activities, teaching, consulting, professional societies.



Non-business Directorships and Trusteeships: Foundations, trusts, hospitals, etc. Noteworthy Special Work, Recognitions: Research, inventions, publications, outstanding artistic or professional works. In addition to this form, you may attach any other information that demonstrates the nominee’s qualifications for consideration. Please attach a photograph.

Return Nomination Forms to: Mail: CU Schools Foundation PO Box 1166 Champaign, IL 61824

Or Email: Send a PDF to [email protected]

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