2016 DISTINGUISHED ALUMNI NOMINATION APPLICATION
Instructions: Please fill out the application fully and email to UH.GCSW.AA@GMAIL.COM. The chosen alumni
member will also be applied to University of Houston Alumni Association Distinguished Alumni Nominations in
September 2016. If you have any questions, please feel free to contact UH GCSW Alumni Association Board
President, Deborah Elizondo-Brady, LMSW at 281-813-4313 or debelizondo@yahoo.com.
Deadline Application Date: January 30, 2016
Person Making Nomination:
Contact Phone:
Contact Email:
Alumni Name:
Graduation Year:
License:
Address:
Telephone #:
Job Position:
Employer:
Section 1: Explain in detail why you think your Nominee should be the 2015 Distinguished UH GCSW Alumni.
Please focus on the Principles & Values of the Social Work Profession:
 Service To The Community
 Commitment To Client/Families Focusing On Self-Determination
 Dignity & Self-Worth Of Clients, Communities & Populations Focusing On Cultural Competence & Social
Diversity
 Social Justice
 Importance Of Human Relationships
 Personal Integrity
 Competence
Section 1: (Can write or type up separately and attach to application.)
Section 2: Explain in detail why you think your Nominee should be the 2015 Distinguished Alumni for the UH
Alumni Association. Focus on how the Alumni represent the University of Houston and can be a spoke person for
the University in our community.
Section 2: (Can write or type up separately and attach to application.)