MAA Alumni of the Year Nomination Form

Your Name

Your Email

Nominee’s Name

Nominee’s UCSF Class/Affinity

How has your candidate contributed to their specialty?

How has your candidate represented UCSF in their local community?

Where is the candidate in the course of their career?

If you have examples that speak to your nominee’s unique qualifications, please attach them here.

Maximum 5 files.
5 MB limit.
Allowed types: gif jpg png txt rtf html odf pdf doc docx zip.

If you have supporting letters from colleagues or peers, please attach them here.

Maximum 5 files.
2 MB limit.
Allowed types: txt rtf pdf doc docx odt ppt pptx odp xls xlsx ods.

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