Preparing tomorrow’s psychologists for a diverse world

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Outstanding Alumni Nomination

Thank you for taking the time to make a nomination for the School of Professional Psychology Outstanding Alumni Award. Please complete the form with as much information as you can.

You may also fill out this form, print it and send it along with additional supporting items that you wish to submit to:

School of Professional Psychology
Office of Alumni Relations
110 Health Sciences
3640 Colonel Glenn
Dayton, OH 45435
(937) 775-3492
FAX: (937) 775-3493

Nominee

Supporting Evidence

If possible, please send additional supporting documentation such as biographical sketch, curriculum vita, or letter(s) of nomination (email, mailing address, and fax number are listed below.)

Nominator

If you're nominating yourself, please leave this section blank.