University of Washington Alumni Association
Meet. Learn. Cheer. Travel. Act.
http://www.UWalum.com

Distinguished Service Award

Use the form to submit basic information and a description of why your nominee should receive the DSA Award. Any supporting documents (curriculum vitae, newspaper clippings, publications, etc.) must be sent by mail.

Send supporting documents to:
Kyle Funakoshi
UW Alumni Association
4333 Brooklyn Ave NE
Seattle, WA 98195

The deadline for submission is August 31, 2012.

DSA Nomination Form

Please fill out the following form to nominate someone for the Distinguished Service Award. Mandatory fields are marked with *

Nominee Information

Nominee Name *:
Class Year (of first degee if more than one) *:
Mailing Address:
City:
State/Province:
ZIP/Postal Code:
Country (leave blank if U.S.):
Phone Number:
Please explain why you feel this nominee should receive the University of Washington's Distinguished Service Award *:

Your Information

Your Name *:
Mailing Address:
City:
State/Province:
ZIP/Postal Code:
Country (leave blank if U.S.):
Phone Number:
E-mail Address *:

Questions?
Please contact Kyle Funakoshi at 206-543-0540 or kyfu@uw.edu.

Become a Fan

UWAA on Facebook

Connect with the UWAA on Facebook and be the first to hear about special events and giveaways.

Upcoming Events

Love the UW? You've got to be a member! Join UWAA now.