College of Veterinary Medicine - Cornell University

Daniel Elmer Salmon Award for Distinguished Alumni Service

Nomination Form for 2013

Click on the links for a full description of the award, to view a sample nomination and to see a list of previous recipients.

The Daniel Elmer Salmon Award for Distinguished Alumni Service honors Cornell Veterinary College graduates who have distinguished themselves in service to the profession, their communities or to the College.

Nomination, which should not exceed 1000 words in total, must be received by May 1, 2013, to be considered for 2013.

Should a nominator wish to re-nominate an alumnus/a from the previous year, a revised nomination form must be completed for the candidate to be considered.

 

* denotes required field
*Nominee:		*DVM Year:
Home Address:
*Phone: (Home)		(Mobile or Business)
Business Address:
Email:
*Nominator:		Year (if applicable):
Address:
*Phone:		Email:
Please indicate the area of focus for which the Nominee is being considered: (Mark off all that apply)
	Commitment and accomplishments related to teaching, research and/or the clinical practice of veterinary medicine
	Commitment and accomplishments related to supporting the NYS College of Veterinary Medicine and Cornell University
	Commitment and accomplishments related to organized veterinary medicine
	Commitment and accomplishments related to civic organizations, the nominee's community and/or society as a whole
Please provide information that will describe and support the nominee's commitment and/or accomplishments for each of the categories that you have selected above. This can include such things as leadership positions held, programs and/or published articles, citations of recognition, as well as other information you deem appropriate. Documentation of support should not exceed 1000 words in total.
(1) Teaching, research and/or the clinical practice of veterinary medicine
(2) Supporting the College of Veterinary Medicine and Cornell University
(3) Organized veterinary medicine
(4) Civic organizations, the nominee's community and/or society as a whole
Summary: In 3 or 4 sentences, why is this nominee a stand out among Cornell University College of Veterinary Medicine graduates?
Please provide at least 2 additional individuals, including their contact information, who could be called upon to provide further support of the nominee's selection. At least one of these references does need to be a graduate of the NYS College of Veterinary Medicine.
Names and contact information of up to three additional individuals to support nomination
*Name:		CU CVM Grad:
Email:		*Phone:
*Name:		CU CVM Grad:
Email:		Phone:
Name:		CU CVM Grad:
Email:		Phone:
Please print a copy of this page for your records. If you have supplied your email address then you will receive a copy of this nomination.
Notification by the Alumni Association Award Committee will be made no later than September 1.
Office of Alumni Affairs & Development
(607)253-3716