2021 Alumni Awards Nomination Form

2021 UIC College of Pharmacy Alumni Awards Nomination Form

1. Nominee Name:

2. Please select the award type:

2. Please select the award type:

RISING STAR AWARD: Recognizes young alumni who have already distinguished themselves in their professional achievements; Have earned first pharmacy degree within the last 10 years from the UIC College of Pharmacy; Must be able to be present to receive the award.

JESSE STEWART SERVICE AWARD: This award, named in honor of a former faculty member, recognizes a person who has been generous in their service to the profession, the community and/or the College. The honoree does not need to be an alumnus of the College; Must be present to receive the award; Open to alumni, faculty and friends of the College.

ALUMNUS OF THE YEAR: One of the highest honor given to an alumnus by the College of Pharmacy, the award recognizes distinguished careers in pharmacy, service to the profession, and loyalty to the College. Recipient must have a distinguished career (administrator, author, business, educator, practice, research, etc); Be a leader/innovator in the profession contributed to the profession; Must be present to receive the award; Must be a graduate of the University of Illinois College of Pharmacy.

3. UIC COP Graduation Year(s):

4. Phone: answer must be phone number with area code like 217-333-1000

5. Email: answer must be an email address

6. If known, please list nominees involvement with the UIC College of Pharmacy. (Preceptor, Mentor, Board Member, etc.)

Nominator Information Please enter your contact information below.

7. Name:

Nominator Information Please enter your contact information below.

8. Address:

9. City:

10. State:

11. ZIP: answer must be a zipcode like 61864 or 61864-8180

12. Phone: answer must be phone number with area code like 217-333-1000

13. Email: answer must be an email address

Please include Nominee's CV and one formal Letter of Recommendation

14. Letter of Recommendation (maximum file size: 15MB) answer must be an email address

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15. Nominee's CV (maximum file size: 15MB) answer must be an email address

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Questions? Please contact Deb Fox at dfox4@uic.edu or (312) 996-0160.

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2021 Alumni Awards Nomination Form

2021 Alumni Awards Nomination Form

1. Nominee Name:

2. Please select the award type:

3. UIC COP Graduation Year(s):

4. Phone: answer must be phone number with area code like 217-333-1000

5. Email: answer must be an email address

6. If known, please list nominees involvement with the UIC College of Pharmacy. (Preceptor, Mentor, Board Member, etc.)

7. Name:

8. Address:

9. City:

10. State:

11. ZIP: answer must be a zipcode like 61864 or 61864-8180

12. Phone: answer must be phone number with area code like 217-333-1000

13. Email: answer must be an email address

14. Letter of Recommendation (maximum file size: 15MB) answer must be an email address

15. Nominee's CV (maximum file size: 15MB) answer must be an email address

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