Bishop's University > Top10 > Nomination Form

Nomination Form

Please complete the information requested below if you would like to nominate someone or are interested in becoming a nominee. Nominees will be contacted via email to complete a short online application process. The completed application will be assessed by a Selection and Advisory Committee made up of past winners.

The deadline to submit a nomination is Monday, April 8, 2013.

Nominee Information

Name of Nominee:*

Bishop's Graduation Year:*

Nominee Phone:*

Nominee email:*

Employer:

Current Position:

Briefly state why you or your nominee should be recognized as part of Bishop's Top 10 After 10 (optional):

Nominated by

Nominated by (if different from above):

Phone:

Email:

Submitting

I prefer my nomination to remain confidential

Personal information collected on this form will be kept confidential and will only be used to determine eligibility and to notify recipients of Bishop’s Top 10 After 10.

If you have any questions, please write to 10after10@ubishops.ca