Salem State College
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Salem, MA 01970
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Alumni Affairs

Outstanding Social Work Award 2008 Nomination Form

The Friends of the School of Social Work's Outstanding Social Worker Alumni Award honors alumni, who have:

shown dedication to their field,
made outstanding contribution to the social work profession, and
performed outstanding service in their chosen area

Please provide as much biographical information as possible to help the screening committee with their decision. Nominations need to be completed on or before March 17, 2008.

Print Nomination Form [PDF 12KB]

Your Nominee

Nominee's Name

Class Year

BSW and/or MSW

Address


(Street Address Line 1)

(Street Address Line 2)

(City)	(State)	(Zip Code)

Phone Number

	Living
	Deceased

Reason for Nomination

Remember to include detailed information about the individual nominee. The more information the selection committee has to consider the better the opportunities for recognition. Please attach any supportive material relevant to this nomination.

Person Making the Nomination
Your Name
Phone Number
Relationship to SSC

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