Mortar Board Alumni Award Nomination Form
Deadline: December 15

Mortar Board

You can submit your nomination by using the online form below or by downloading a Word document.

  1. To use this form: Scroll down on this page, select type of award, and then, scrolling downward, fill in all of the requested information. When you are satisfied with the information you have entered, click the “Submit Nomination Now” button. You will receive a reply saying that your nomination has been submitted.
  2. To use a Word document: Download this fillable Word document. Place the information about your nominee into the form. Be sure to save the form on your computer (e.g., “Save as”  JaneDoeNomination). When you are satisfied with the document, save it a final time and then attach it to an email addressed to mortarboard@mortarboard.org or submit to:

Mortar Board National Office
1200 Chambers Road, Suite 201
Columbus, OH 43212
mortarboard@mortarboard.org

Purpose of the awards:
These awards are given by Mortar Board, Inc. and the Mortar Board National Foundation to alumni who have demonstrated Mortar Board’s continuing commitment to the ideals of scholarship, leadership and service. These alumni are models for the collegiate members as well as living illustrations of what Mortar Board stands for.

Eligibility of Award Recipients:
Any alumnus or alumna of Mortar Board, initiated as an undergraduate, who is not currently a National Council member, a section coordinator, a National Foundation trustee, or an advisor to a collegiate chapter, is eligible. Honorary members are eligible five years after the date of their initiation. Previous recipients are not eligible to receive another award.

Eligibility of Nominators:
Nominations may be submitted by alumni chapters, collegiate chapters, or individual Mortar Board members.

Award Presentation:
The award(s) will be presented during the Mortar Board National Conference, held the third weekend in July. Attendance at the conference is desired but not essential. Recipients’ expenses will be paid by Mortar Board to attend the conference.  Conference details will be available from the National Office in April.

Photographs (for publicity purposes):
All award recipients will be publicized in the Forum magazine and on the national website. A photograph is requested with the nomination form for this reason. Black/white, color and digital photographs are accepted. Don’t let the lack of a photo keep you from meeting the deadline. Photos can be emailed to mortarboard@mortarboard.org at your convenience. Please be sure to type "Alumni Award Nominee Photo" in the subject line.

Type of Award:
This nomination form is to be used for two different awards. Check below the award for which the candidate is being nominated. You may only select one award.

Alumni Achievement Award

This award is given to Mortar Board alumni who:

  • Have demonstrated outstanding achievement in their profession or their career, or are noted for outstanding community service, or both;
  • Have shown a continuing commitment to the Mortar Board ideals of scholarship, leadership, and service;
  • Are an outstanding role model for collegiate members;
  • Are between five and 40 years from their undergraduate degree.  

Distinguished Lifetime Membership Award

This award is given to Mortar Board alumni who:

  • Have retained connections or contacts with Mortar Board in either collegiate or alumni areas;
  • Have demonstrated outstanding community or campus service on a national or international plane;
  • Epitomize the true meaning of a Lifetime of Service;
  • Have had substantial years pass since being awarded their undergraduate degree. 
Nominee Information
First name:
Middle (or maiden, if applicable):
Last:
Home Address
Street Address:
Address line two (optional):
City:
State:
ZIP:
Work Address
Street Address:
Address line two (optional):
City:
State:
ZIP:
Contact Information
Home phone:
Work phone:
E-mail address:
Preferred Salutation
Mr.
Mrs.
Ms.
Dr.
Other (please specify):
.
Mortar Board Information
College/University where initiated :
Chapter name:
Year initiated:
Recommedation

In the area below, please write a brief summary addressing the nominee’s qualifications for the award based on the criteria above (i.e. 800 words). Please email additional material that documents the nominee's achievements (e.g., letters of support, clippings).  Attach a vita if available. If you would choose to email a Word or text document rather than type your recommendations below, please email it along with other materials to mortarboard@mortarboard.org.

Submission information

Name of submitter

(alumni chapter, collegiate chapter or person completing form)
Street address:
Address line two (optional):
City:
State:
ZIP:
Phone number:
E-mail address:
Name of contact person (if different than name of submitter):
Please initial, indicating that this information is correct to the best of your knowledge.
Date:
Any additional notes?
If you are experiencing any problems with this online form, please contact the Web master directly during business hours at 800-989-6266 ext. 106 or mortarboard@mortarboard.org. You may choose to print a copy of this form for your records.