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Distinguished Alumni Award Nomination Form

Learn more about the Distinguished Alumni Award - by clicking here.

For questions, please call 717-871-7551 or 800-681-1855 or email: alumni@millersville.edu

You may also attach any accompanying documents.

Thank you for your submission!

Nominations for the 2026-2027 cycle will close on March 15, 2026.

Distinguished Alumni Award

A. Nominee Information
Nominee’s Name: Nominee’s Name: First Last
Class Year:
Address:
Address:

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Home Phone Number: Home Phone Number: - ### - ### ####
Email (if known):
B. Nominator Information
Name: Name: First Last
Class Year (if MU grad):
Address: Address:
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Day Phone: Day Phone: - ### - ### ####
Evening Phone: Evening Phone: - ### - ### ####
Preferred Email:
MUAA Distinguished Alumni Award

This award may be given to any living alumni member who is a graduate of Millersville University and who has been distinguished in such a way to bring honor to the individual, to the University and/or the MU Alumni Association. Nominations for this award may be submitted by any person familiar with the achievements of an individual’s distinguished endeavor.
C. What was the service or professional achievement/contribution to be recognized? (Briefly describe its nature and purpose and the goals achieved.)
D. Where was the service or professional achievement completed (or still active)? Was it rendered to the MU alumni constituency, the state, or nation? (Please include all details.)
E. Analysis of Achievement: Please conclude this nomination by assessing the nominee’s achievements in total. Indicate the impact the service had upon the Alumni Association, the University, community, and/or individual. Please include any additional material which will further substantiate the analysis of this service. Additional information can be uploaded below:
F. Analysis of Achievement: Please include this nomination by assessing the nominee’s achievement in total. Indicate the impact the service had upon the Alumni Association, the University and/or individual. Please include any additional material which will further substantiate the analysis of this service.
Nominator signature:

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Full Name

I understand this is a legal representation of my signature.
Date: Date: / MM / DD YYYY
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Distinguished Alumni Award Nomination Form

Distinguished Alumni Award

Distinguished Alumni Award

A. Nominee Information

B. Nominator Information

MUAA Distinguished Alumni Award

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