150th Anniversary Alumni AWARDS GALA · 2017. 7. 26. · 150th Anniversary Alumni Awards Gala Since B@@@, Alumni Awards have been presented to Chicago State University’s most accomplished,

150th Anniversary Alumni

AWARDS GALACelebrate the Past, Secure the Future

NOMINATION FORM

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The Chicago State University 150th Anniversary Alumni Awards GalaSince 2000, Alumni Awards have been presented to Chicago State University’s most accomplished, innovative, and influential alumni. Alumni Award winners add to our university's rich history of visionaries who make the CSU proud.

Each year Alumni Awards are presented in thirteen categories. The opportunity to honor alumni from around theworld would not be possible without the assistance of the Chicago Teachers College/Chicago State UniversityAlumni Association, alumni, and the community. The CTC/CSU Alumni Award may be awarded posthumously inany category.


Complete and mail the nomination form to Chicago State University or email form to [email protected]

Nominations may also be submitted via email or mail to the Office of Alumni Relations. All nominations must consist of a completed nomination form. Additionally, nominations may include up to two letters of recommendation and a brief biography, CV or resume detailing the nominee’s accomplishments. Neither nominators nor those submitting lettersof recommendation are required to be alumni. The nomination deadline for the 2017 Alumni Awards is August 28, 2017

For more information, please contact the Office of Alumni Relations at [email protected] or 773.995.2050. The 2017Alumni Award recipients will be selected in August, and the awards will be presented at the 150th Anniversary AlumniAwards Gala on Saturday, October 14, 2017 at the Museum of Science + Industry Chicago.


Excellence in Education AwardThis honor is bestowed upon an alumnus/alumna who has been recognized as an outstanding teacher or administrator in the field of education, and who hasmade a difference in the lives of students through his/her years of dedication and service.

Golden Alumna/Alumnus AwardThis award is bestowed upon an alumna/alumnus who is 70 years of age or older in honor of consistentservice, commitment and dedication to the advancementof Chicago State University.

Lifetime Achievement AwardThis is the highest honor bestowed by the CTC/CSU Alumni Association. It is presented to an alumna/alumnus who has demonstrated significant achievementand commitment to excellence throughout her/hisprofessional and personal life, and who has established

a record of accomplishment that reflects admirably or brings honor to his/her alma mater.

Award Categories


Outstanding Achievement in Community/Public ServiceThis honor is bestowed upon an alumna/alumnus who has consistently demonstrated extraordinarycommitment to public and private institutions and

organizations that work to improve the quality of life forpeople in their communities and/or society in general.

Outstanding Achievement in Health SciencesThis honor is bestowed upon an alumna/alumnus in the field of health sciences who, through her/hisoutstanding involvement and dedication, has madesignificant contributions of leadership or service that have enhanced the lives of others.

Outstanding Achievement in MedicineThis honor is bestowed upon an alumna/alumnus in the field of medicine who, through her/his outstandinginvolvement and dedication, has made significantcontributions of leadership or service that have enhancedthe lives of others.




Outstanding Achievement in the ArtsThis award is presented to an alumna/alumnus who has excelled in the field of arts and/or entertainment.

Outstanding Business/Professional AchievementThis honor is bestowed upon an alumna/alumnus who has attained outstanding success and distinction in his/her chosen business or profession.

Outstanding Achievement in Sports/AthleticsThis honor is bestowed upon an alumna or alumnus who,through their outstanding performances as an athlete orachievements in coaching, officiating, or administrating inthe realm of sports or athletics, has achieved remarkablesuccess. This success, at or for CSU or other institutionsor organizations.

Award Categories


Special Recognition AwardThis honor is bestowed upon an individual who is not a graduate of CTC/CSU, but who has made a significant contribution to the advancement of Chicago State University.

Outstanding Young Alumni AwardThe award recognizes the contributions of outstandingyoung alumni to society or their profession. Selection

is based upon significant accomplishments in one’s chosen field. This may be measured by noting favorablestatewide, national, or international recognition; honorsfrom associations or employers; or documentationillustrating work that has proved beneficial to apronounced segment of society. The award is given to a Chicago State University alum 40 years of age or younger.


Nominations must be received by August 28, 2017 to be considered for awards recognition. Files are considered active and eligible for an award for two years and may be updated at any time. Please send nominations to: Chicago State University

Office of Alumni Affairs, 9501 S. King Drive – Cook ADM 322, Chicago, IL 60628, or email to [email protected].

For additional information call 773.995.2050.

Outstanding CSU Staff Member This award is bestowed upon an active or retired ChicagoState University staff member who is a or non-graduateof the institution and has demonstrated commitment anddedication to the university and its mission by providingexceptional support for students.

Outstanding Faculty Member This award is bestowed upon an active or retired faculty member at Chicago State University who hasdemonstrated exceptional commitment and dedicationto education, students and the advancement of ChicagoState University. (This award is not limited to CTC/CSU alumni.)

Award Categories


Date _________________________

Please print or type information

Nominee’s Full Name ___________________________________________________

Maiden Name ________________________________________________________

Member of the Alumni Association � YES �NO

� Home � Business Phone Number____________________________________

Email Address ________________________________________________________

Class Year(s) Degree(s)_______ Department(s)/School(s) _______________________

Major(s) _____________________________________________________________

Preferred Address (Street) _______________________________________________

City_____________________________________State______ ZIP _____________

Present Occupation (title and company, profession, etc.) ________________________

Nominated By___________________________________ Date ________________

Member of the Alumni Association � YES � NO � CSU STAFF

Email Address ________________________________________________________

Address _____________________________________________________________

City_____________________________________State______ ZIP _____________

Please include a statement describing your reason for making this nomination. Includebiographical sketch, resume and any other available supporting documentation.

Award Categories(Please check one category only. Multiple

checks will result in elimination.)

� Excellence in Education Award

�Outstanding Achievement in Medicine

�Golden Alumna/Alumnus Award

� Lifetime Achievement Award

�Outstanding Achievement in the Arts

�Outstanding Business/Professional Achievement

�Outstanding Achievement in Community/Public Service

�Outstanding Achievement in Health Sciences

�Outstanding Achievement in Sports/Athletics

� Special Recognition Award

�Outstanding Young Alumni Award

�Outstanding CSU Staff Member

�Outstanding Faculty Member

150th Anniversary Alumni

AWARDS GALACelebrate the Past, Secure the Future

NOMINATION FORM



Documents

150th Anniversary Alumni AWARDS GALA · 2017. 7. 26. · 150th Anniversary Alumni Awards Gala Since B@@@, Alumni Awards have been presented to Chicago State University’s most accomplished,