Baylor Alumni Association

Distinguished Baylor Black Alumni Award

Please complete this form in its entirety. Nominating statements must be limited to 500 words or less
and should be directed toward the specific purpose of the award.

Additional supporting information, such as biographical sketch, curriculum vitae, or resume,
is welcomed by the selection committee and may be attached at the bottom of this form.
Please fill out a separate form for each additional nomination.

If you have any questions, please contact Marie Brown at mariebrown92@hotmail.com.

Nomination form(s) and supporting documents may also be mailed to:
Baylor Black Alumni Awards, c/o Marie Brown, 1209 Morning Dove Drive, Aubrey, TX 76227.

Deadline for nominations is May 17, 2013.

Distinguished Baylor Black Alumni Award Nomination

Fields marked * are mandatory.

Person you wish to nominate:*

Nominee's class year:

Nominee's email:*

Nominee's phone number:

Nominee's address:

Nominee's city:

Nominee's state:

Nominee's zip:

Nominated by: (Your Name)*

Nominator's email:*