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Alumni of Distinction Nomination Form
PDF nomination form
NOMINEE INFORMATION
We will talk to the nominator before reaching out to the nominee if they are successful in the selection process.
Nominee first and last name
*
Nominee email
*
Enter Email
Confirm Email
Nominee home phone
*
Nominee Mobile
Which institution did the nominee attend?
*
Campion High School
Campion at the University of Regina
both
Briefly tell us why you think your nominee should be an Alumnus of Distinction
*
NOMINATOR INFORMATION
You may be contacted for more detailed information about your nominee during the selection process.
Nominator first and last name
*
Nominator Email
*
Enter Email
Confirm Email
Nominator Home phone
*
Nominator Mobile
COMPLETE & SUBMIT
Be sure to review all the information you have provided in this form to ensure accuracy before clicking submit. If you have any questions, reach out to Campion Alumni Relations at 306-586-4242 or campion.alumni@uregina.ca
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