Birmingham City University Alumni of the YearNOMINATION FORM

Nominator’s Details

Title:       Name:      Address:      City:       County:      Postcode:       Country:      Telephone:       Mobile:      Email:      

I am: Current staff Former staffCurrent student Former student

Nominee’s Details

Please provide as much information as possible about the person you wish to nominate. If you do not know some of the information requested please leave these sections blank.

Title:       Name:      Address:      City:       County:      Postcode:       Country:      Telephone:       Mobile:      Email:      Course Studied:      Year started:       Year completed:      I wish to nominate the person above for the following Alumni of the Year in the following categories:

Community engagementEnterprise and InnovationExcellence in sports or the arts

In addition to the nomination form appropriate supporting material may be submitted e.g. newspaper or magazine clippings. Please list any supporting material you have enclosed:      

All nominations for Alumni of the Year must remain private and confidential until an official announcement is made by Birmingham City University Alumni Association.

Supporting Statement

Please provide details of how the nominee meets the criteria for the specified award:     

Please note that if you are nominating yourself you must obtain two letters of support from independent referees with this nomination form. Support letters may not be written by members of your family.

Nominators Signature:      Date:     

Completed forms should be marked ‘private and confidential’ and returned to:Helen GearyAlumni Relations ManagerBirmingham City University Alumni AssociationCity North CampusPerry BarrBirminghamB42 2SU

All nominations for Alumni of the Year must remain private and confidential until an official announcement is made by Birmingham City University Alumni Association.