Distinguished Alumni Award Nomination Form

The UI Carver College of Medicine Distinguished Alumni Awards is the highest honor that the College bestows on its graduates. Throughout the country and world, alumni and friends are influencing the delivery of health care, changing the course of medical education, and conducting groundbreaking research. Please help us identify these alumni for consideration of the College’s highest recognition.

All graduates of the College’s medical education, residency and fellowship training, associated medical sciences and basic science programs are eligible for nomination.

Nominators should submit the following by October 30, 2009 either via email at
medicine-alumni@uiowa.edu, or by mailing to:

• Nomination Form
• Nominee’s Vita
• 2 or more additional letters of support
• Any additional information that would substantiate the nomination