Nomination Form

Nominee Information

Nominee Name*

First Last

Program Area(s), Degree(s) Earned, and Graduation Year(s) in the Department of Civil, Construction and Environmental Engineering (If not alumni, put N/A)*

Is the nominee deceased?

Yes
No

Nominee family member

First Last

Nominee Contact Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Nominee Contact Phone

Nominator/Nominee Relationship

Nominee Contact Email

Nominator Information

Nominator Name

First Last

Nominator Publicity

Is nominator okay with their name being shared with nominee?

Yes
No

Nominator Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Nominator Phone*

Nominator Email*

Summary of Award Nomination

Please provide a summary of why the nominee is qualified for the award in 200 words or less

Nominator Statement*

Accepted file types: doc, docx, pdf, Max. file size: 64 MB.

A statement that expands beyond the summary and resume, if provided, to address the award criteria. It is beneficial to describe and provide context on specific details of achievements, recognitions, and international/national/regional/state/local contributions, which, in the opinion of the nominator, qualifies the nominee for induction as a Hall of Fame member or a Distinguished Alumni. Maximum of three pages. Contributions could include excellence in the research community, engineering industry, mentoring, leadership, or advancing the state of understanding.

Nomination Information

Please combine documents into a single PDF file before submission. (List of potential information that would be helpful in considering the nomination, could be included in CV format)

List of degrees with universities and dates.
Professional chronology including organization, business title and dates.
Organizational memberships, including offices held, significant honorary titles, and civic activities.
Significant awards and honors with dates.
List up to fifteen significant achievements/impacts, such as projects, patents, awards, leadership positions, papers, and reserach. Provide a description as necessary for the committee to understand the significance of achievements/impacts.
Major contributions and achievements in the community.
Specific activities in support of the CCEE program at Iowa State University.

File Upload

Please combine documents into a single PDF file.

Accepted file types: pdf, Max. file size: 64 MB.

Name

This field is for validation purposes and should be left unchanged.

Alumni Recognition Nomination Form

Nominee Information

Nominator Information

Nomination Information