Old Rhodian Nomination Form 2015

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Old Rhodian Award Nomination Document
OLD RHODIAN AWARD NOMINATION FORM
Name of Nominee :
Year of First Enrolment at Rhodes:
Area of study at Rhodes:
Name of Nominator
Did you study at Rhodes YES/NO
Year of First Enrolment (if applicable)
Postal Address:
Postal Address:
E-mail:
E-mail:
Telephone:
Home:
Work:
Cell:
Telephone:
Home:
Work:
Cell:
For which Old Rhodian Award are they being nominated :
Distinguished Old Rhodian Award
Emerging Old Rhodian Award (under 40 years)
Please complete the following as appropriate to the nomination/award: (can be submitted on a
separate sheet with the appropriate headings)
Why I believe this person should be considered for this award. (Your personal
recommendation/motivation.)
Professional Achievement (Offices held, Professional Recognitions, Awards, Publications/citations
etc)
Service to Society in General
Old Rhodian Award Nomination Document
Service to the University (Guest Lecturing, Donations, Mentoring etc)
Further Relevant Documentation – list attachments (i.e. CV, list of publications etc)
Statements of Support from others (optional) – please list here and attach.
Please send the completed form together with your covering letter to:
Old Rhodian Award Nomination
Attention: Terryl Mc Carthy
Alumni Relations Office
Alumni and Development Division
Rhodes University
PO Box 94
Grahamstown
6140
Tel: 046 603 8887
E-mail: t.mccarthy@ru.ac.za
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