Please fill out the form completely and hit the submit button at the bottom of the form. Eligibility requirements and criteria are located below the form. All questions can be addressed to alumni@vet.k-state.edu
| WHICH AWARD ARE YOU NOMINATING THE PERSON FOR? | ||
| Award Type: | E.R. Frank Award (See Criteria) Distinguished Alumnus Award (See Criteria) Alumni Recognition Awards (See Criteria) |
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| YOUR INFORMATION | ||
| First Name: | Middle Name: | Last Name: |
| Address Line 1: | Address Line 2: | City: |
| State: | Zip Code: | Home Phone: |
| Work Phone: | E-Mail Address: | Fax Number: |
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| NOMINEE INFORMATION | * Optional | |
| Graduating Class Of: | ||
| First Name: | Middle Name: | Last Name: |
| *Spouses Maiden Name: | Address Line 1: | Address Line 2: |
| City: | State: | Zip Code: |
| Home Phone: | Work Phone: | *E-Mail Address: |
| *Fax Number: | *Birthday (MM/DD/YYYY): | *Birth Place (City,State) |
| *Father's Name: | *Mother's Maiden Name: | |
| *List The Names Of Their Children and Birthdates: | ||
| NOMINEE'S EDUCATION OTHER THAN KSU: | ||||
| Degree: | School: | City: | State: | Year: |
| NOMINEE'S CURRENT PROFESSIONAL MEMBERSHIPS | |
| Check All That Apply: | |
| VMA AVMA AAHA |
AASP AAEP AABP Others |
| NOMINEE'S CURRENT PROFESSIONAL MEMBERSHIPS | ||
| Office | Organization | Dates |
| NOMINEE'S BOARD CERTIFICATIONS | |||
| ABVP | ACVA | ACVM | ACVR |
| ABVT | ACVCP | ACVN | ACVS |
| ACLAM | ACVD | ACVO | ACZM |
| ACPV | ACVECC | ACVP | AVDC |
| ACT | ACVIM | ACVPM | Others |
| OTHER INFORMATION ABOUT NOMINEE |
| History of professional activity: |
| Participation in civic and community: |
| Honorary societies, honors/special awards or recognitions |
Note: Only complete nominations will be considered by the committee.
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ELIGIBILITY REQUIREMENTS E.R. FRANK AWARD Purpose: To honor those veterinarians who have contributed positively and significantly to Veterinary Medicine through their long term service to the Kansas State University, College of Veterinary Medicine. Criteria for Nomination:
Selection: The recipient is selected by the Executive Board of the Veterinary Medical Alumni Association (VMAA), or at the pleasure of the VMAA President, selection may be accomplished by an awards committee established by the Dean of the College of Veterinary Medicine which includes the VMAA President or his/her designated representative. Presentation: The honoree is presented their award at Heritage Evening during the Kansas State University College of Veterinary Medicine’s Annual Conference for Veterinarians the first weekend of June. DISTINGUISHED ALUMNUS AWARDPurpose The Distinguished Alumnus Award provides an avenue for recognizing one or as appropriate, more than one alumni of the Kansas State University College of Veterinary Medicine for their outstanding achievements. Eligibility
Selection: The recipient is selected by the Executive Board of the Veterinary Medical Alumni Association (VMAA), or at the pleasure of the VMAA President, selection may be accomplished by an awards committee established by the Dean of the College of Veterinary Medicine which includes the VMAA President or his/her designated representative. Presentation of Award The honoree is presented their award at Heritage
Evening during the Kansas State University College of Veterinary
Medicine’s Annual Conference for Veterinarians the first weekend of
June. Purpose
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