Smith College Medal Nomination Form

Nominations are received throughout the year, with no deadline and no anticipated timeline for award, should a candidate be selected. The review process is completely confidential and candidates are not notified of their nomination.

Before submitting a nomination, please view the list of Smith College Medalists to be sure your nominee has not already been honored with a Smith Medal.

Nominee Information

First name

Last name

Undergraduate name

Class year

Street address (if known)

Street address line 2

City

State/Province/Region

Zip/Postal code

Country

Nominee"s email address

Profession/Avocation

Provide title and employer, if applicable.

Please state why you think this alum should be considered for the Smith College Medal. How have they "made a difference?" Are they a role model for current undergraduates?

Please be as specific as possible.

Please list contact information of at least three people who have known the nominee in a variety of ways.

Reference #1

Reference #1: Name

Reference #1: Email

Reference #1: Phone

Reference #2

Reference #2: Name

Reference #2: Email

Reference #2: Phone

Reference #3

Reference #3: Name

Reference #3: Email

Reference #3: Phone

Reference #4

Reference #4: Name

Reference #4: Email

Reference #4: Phone

Reference #5

Reference #5: Name

Reference #5: Email

Reference #5: Phone

IMPORTANT: Strict confidentiality is maintained throughout this nomination process. Please send as much supplemental material about your nominee as possible. A resume/curriculum vita, newspaper articles about the nominee, commendations, honors received, and any other information you have will be most helpful.

Do you have supplemental materials to submit at this time?

Yes

Please provide links or upload files below.

File