The Faculty of Engineering Alumni Achievement Medal program has been established to recognize the accomplishments of Waterloo Engineering alumni.

This prestigious award, created in 1994, was established to provide tangible recognition of alumni who have distinguished themselves through their professional achievements, community service or academic excellence.

 

Individual Medal Category

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If nominating for more than one category, check all that apply:

	Professional Achievement - recognizes the accomplishments of Waterloo Engineering alumni in business, engineering/architecture/entrepreneurship, and/or management.
	Community Service - recognizes the accomplishments of Waterloo Engineering alumni in volunteer leadership and humanitarian endeavours.
	Academic Excellence - recognizes the accomplishments of Waterloo Engineering alumni in the pursuit of academic careers and research.

 

Name of individual responsible for nomination

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Name:

Address:

City:

Postal Code:

Email:

Phone Number (daytime):

Phone Number (evening):

Primary Contact Person:

Job Title:

Relationship to Nominee:

 

Nominee Information:

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Name:

Address:

City:

Postal Code:

Email:

Phone Number (daytime):

Phone Number (evening):

Date of Birth (dd/mm/yyyy):

Degree:

Year of Graduation:

 

Required Documents:

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Brief description (maximum 500 words) of the nominee's contributions and achievements:

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: