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GW ENGINEERING HALL OF FAME NOMINATION FORMNominator’s NameRelationship to GW:______________________________________________________________________________GWU AffiliationPhoneE-mail AddressNominee’s Personal InformationName:_____________________________________________________________Home Address:_____________________________________________________________City, State, Zip:_____________________________________________________________Home Phone:_____________________________________________________________Job Title:_____________________________________________________________Company:_____________________________________________________________Business Address:_____________________________________________________________City, State, Zip:_____________________________________________________________Business Phone:_____________________________________________________________Cell Phone:_____________________________________________________________Fax:_____________________________________________________________E-mail address:_____________________________________________________________Nominee’s Educational BackgroundCOLLEGECLASS YEARDEGREE/MAJORLevel of Achievement: To what extent the nominee contributed to engineering, technology, or management in a sustained and significant way during his/her professional career? (Minimum of 1 paragraph)Impact within Professional Volunteer Organizations: To what degree has the nominee’s service further enabled his/her organization to meet its objectives? (Minimum of 1 paragraph)Impact on the Greater Engineering Community: To what extent did the nominee’s professional service positively affect the larger engineering community? How far-reaching was the affect? (Minimum of 1 paragraph)Addendums: (If a public biography, resume, copies of news articles, or additional supporting documents are available please include text here or attach to this form.)Please return completed form and any additional information to: Attn: Sarah Coloma, SEAS Office of Development and Alumni Relations, The George Washington University, 800 22nd Street NW, Suite 2885, Washington, D.C. 20052. Nomination forms and any attachments may also be submitted electronically to: seas@gwu.edu ................
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