Distinguished Service Award Nomination Form

Please use the form below to make a nomination for the Distinguished Service Award.

* = required field

Nominee's Name*

Nominee's Home Address*

Phone

Email address

Class Year

Luther Degree/Major

Other Institutions/Degrees

Present Occupation/Title

Professional Positions Held

Professional Awards and Honors Received

Professional Memberships

Community/Volunteer Organization Memberships and Positions Held

Publications/Research

List any Other Reasons You Believe Your Nominee is Qualified for this Award.

Other information such as a nominee's resume or vita, or news articles about their accomplishments may be mailed to: Kirk Johnson, Office of Alumni Relations, Luther College, 700 College Drive, Decorah, IA 52101 or emailed to [email protected]

Your Name*

Your Email Address*

Your Phone*

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