The award will examine accomplishments based, but not limited, on the following criteria:
This award will recognize the important role that the community plays in supporting the University of Waterloo and the Faculty of Engineering.
Address:
City:
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Email:
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Phone Number (evening):
Primary Contact Person:
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Relationship to Nominee:
Date of Birth (dd/mm/yyyy):
Degree:
Year of Graduation:
Brief description as to why this person stands out and how they have made a difference:
A minimum of 2 letters of support from individuals other then family members: