Nomination Form

Describe the reason for your nomination (if more space is required, email
Elaborate on the impact of your nominee’s accomplishments (ex: created change, created stability, improved lives)?

Please note

  • By submitting this nomination, you understand the award selection committee many contact you with follow-up questions.
  • Nominations will be considered valid for a three-year-period.
  • You do not need to be an alumnus to submit a nomination.  

Suggested documents – If possible, email the following documents to to assist the selection committee by expanding on the nominee’s story and character:

  • Resume
  • Personal anecdotes
  • Reference letters


Suggested supplementary documents can be emailed or mailed to:

Dalhousie University, Agricultural Campus
Office of Advancement
Alisha Johnson
PO BOX 550
Truro, NS
B2N 5E3

Thank you for participating in the celebration of Dalhousie’s outstanding alumni!