Averett Alumni Awards Nomination Form

Alumni, faculty, staff, and friends of alumni are welcome to submit nominations for any of the award categories listed below.

Please be sure to submit all required information. Incomplete nominations may not be considered by the Awards Committee. Additional information (articles, letters of support, etc.) may also be submitted. Please also include a letter of support. We encourage you to ask multiple people to fill out nomination forms as that will be seen as additional support for the nominee.

The Nominee should be able to attend Homecoming on October 21, 2017,to receive their award.

DEADLINE: Submit nomination forms and other pertinent information to the address on the back of this form by Wednesday, April 9, 2017.

Award nominations are welcome throughout the year preceding the deadline. They will be saved for consideration for one year.


Award Category

Please select the award that best reflects the nominee’s achievements and contributions. Nominees not selected will remain in the nomination pool for one additional year before a full nomination must be resubmitted.

Fields marked with an * are required

Please describe why you think this person deserves the award(s) for which they are nominated. Please include additional sheets if necessary and a copy of their curriculum vitae or resume if available.

(Please include such details as business/professional accomplishments; community/professional affiliations; awards, honors or decorations; publications; volunteer service to Averett or other organizations, etc.)

Nominator Information

For further assistance contact Dan Hayes, Director of Alumni Relations @ (434) 791- 7252 or dhayes@averett.edu