The Rutgers African-American
Alumni Alliance, Inc.

Nominee Contact Information (if nominee is deceased, please provide information of a spouse or relative if possible)

Name

Phone

Email

Address

City State Zip

Your Contact Information (if different)

Name

Phone

Email

Rutgers University College(s)/Schools(s)
This person is a non-alumni nominee for an honorary lifetime membership

Nominee Accomplishments

Nominee Biography Required (Approximately 500 words) - you may cut and paste

Select one:

I have contacted the nominee or family member to inform him/her of this nomination.
I am nominating myself.
This is a historical nominee (i.e., early graduate, historical first or someone whose family will be difficult to locate).

Supporting documents (Resume/CV, Press Releases and Articles, Awards, Publications, Support Letters, Other)

Email electronic documents to

or Mail hard copies to:

Rutgers African-American Alumni Alliance
Hall of Fame
PO Box 422
Piscataway, NJ 08855-422