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Alumni & Friends

Outstanding Social Work Award Nomination Form

The Friends of the School of Social Work's Outstanding Social Worker Alumni Award honors their alumni who have shown dedication to the field of social work by:

making outstanding contributions to the social work profession
performing outstanding service in their chosen area
nurturing professional development of social workers

Please provide as much biographical information as possible to help the screening committee with their decision. Please fill out the form below and submit your nomination form. Nominations need to be completed on or before Friday February 3, 2012.

Print Nomination Form [DOC 27KB]

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 Salem State University

Alumni & Friends

Outstanding Social Work Award Nomination Form

Reason for Nomination

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