Purpose The GW PT Alumni Award recognizes outstanding leadership and service of a GW PT alumnus or alumna. Community service, professional achievements and other such accomplishments are considered, but are secondary to varied service to the University and involvement with the PT program post graduation. Award Criteria Any alumnus/alumna who embodies the mission and vision of the GW PT Program in their daily life. The recipient will demonstrate this through: distinguished service to the GW DPT Program and/or University excellence in clinical practice research contributions and/or advocacy that advance the profession community service activities Nominating Candidates Any person may recommend an alumnus/alumna for the GW PT Alumni Award. The nomination should include the sections outlined in the form as well as a brief summary of the nominee's service to the Program/University, community service activities, and their professional accomplishments. Presentation of the Award The GW PT Alumni Award will be presented during the GW PT Awards Ceremony in May. The recipient of the award must be present to accept the award. Thank you for your interest. The 2018 nomination process is now closed. We will begin our review of 2019 candidates in January 2019. Nomination Information * Nominee Name (current) * Nominee Name (while in the program) * Email Address * Phone * Address Suite/Floor * City * State * Zip Code *GW DPT Graduation Year Please select 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 Please provide a brief summary of the nominee's accomplishments as they relate to the award criteria (Maximum characters: 1000) You have characters left. * Submitted by (Name): * Submitted by (Email): * Submitted by (Phone): * Submitted by (Address) Suite/Floor * City * State * Zip Code I attest that the information provided is a fair and accurate representation of the nominee. (Electronic Signature) For any questions related to this form, please contact firstname.lastname@example.org. You may be contacted to provide additional information pertaining to the nominee.