Distinguished Alumni Award Nomination Form

For questions please call 717-871-7551 or 800-681-1855 or

email: mualumni@millersville.edu

You may also attach any accompanying documents.

Deadline: The deadline is February 23.

Distinguished Alumni Award

Distinguished Alumni Award

  • A. Nominee Information

  • Nominee’s Name: Nominee’s Name: *
  • Address:
  • Home Phone Number: Home Phone Number: * - -
  • B. Nominator Information

  • Name: Name: *
  • Address: Address: *
  • Day Phone: Day Phone: * - -
  • Evening Phone: Evening Phone: - -
  • 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.

  • Draw or Type
    I understand this is a legal representation of my signature. Clear
  • Date: Date: * / /
    Pick a date.