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Fellowship Honouree Nomination Form

If you wish to submit a nomination for Fellowship Honouree, please provide your contact information, as well as the name of the nominee and reason for nominating him/her. When complete, you can submit the form online. If you have any questions, please contact Lynn Graham at 519-888-4567 ext 37775 or l2graham @ uwaterloo.ca
Nominator
First Name: Last Name Year of Graduation
Email Phone    

Nominee
First Name Last Name Year of Graduation (if known)
Email Phone    

Reason for nomination: