Alumni Award Nominations - UW Medicine Alumni

Every year, the UW Medicine Alumni Association recognizes exceptional alumni with a series of awards. Read more about the awards.

Please note, nominations for the 2023 Distinguished Alumni Awards are now closed. All nominations received after December 31, 2022 will be considered for the 2024 awards cycle. To submit nominations, please complete the form below, and provide the nominee's C.V. At least one letter of support is recommended.

IMPORTANT: We strongly recommend first writing your answers (and saving them) in a word processing program in case you run into any unexpected technical difficulties when submitting this form. Or you can download a Microsoft Word template to fill in offline.

About the Nominee

Nominee's Name*

First Last Suffix

Home Phone

Work Phone

Mobile Phone

Email

Enter Email Confirm Email

Award Nomination*

UW Medicine Degree(s) (Select all that apply)

M.D.
Ph.D.
M.D./Ph.D.
Residency
Fellowship
P.A.
Master's
Bachelor's

UW Medicine graduation year(s)

Qualifications

Please summarize why you believe the nominee is deserving of this recognition.*

Please provide highlights from the nominee's training and career that you believe are most relevant to the award for which you are nominating him/her.

Summary of volunteer and service work*

Professional achievements and affiliations*

Publications, distinctions, honors and awards*

Upload nominee's C.V.

Max. file size: 50 MB.

Upload letter(s) of support

Max. file size: 50 MB.

At least one letter of support is recommended in addition to your nomination submitted here. Please combine all letters into a single file. If you prefer, you may send letters by email to medalum@uw.edu. Please include the name of the nominee in the subject line. If you have any questions about this process, feel free to reach out to us at that email as well.

If letters of support are being sent by email, please let us know the name(s) of the individual(s) who will be sending them.

Your Information

If you are helping someone submit this form, please enter the nominator’s name and contact information.

Name*

First Last Suffix

Title*

Employer

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Email*

Enter Email Confirm Email

Relationship to the nominee*

Are you a graduate of -- or did you complete a residency or fellowship at -- the UW School of Medicine?

Yes
No

UW Medicine Degree(s) (Select all that apply)

M.D.
Ph.D.
M.D./Ph.D.
Residency
Fellowship
P.A.
Master's
Bachelor's

UW Medicine graduation year(s)

Award recipients enjoy being celebrated by their peers and colleagues. Should your nominee be selected for a 2024 Distinguished Alumni Award, will you be available to attend the awards recognition celebration, Friday, May 31, 2024, in Seattle?

Yes
No