Honorary Degree Nominations

Nomination Form For Honorary Degree

* indicates required field

A nominator letter of support is to accompany this form. Three additional reference letters with original signatures are required for the nomination process. The application will not be considered complete until the reference letters accompanying the nomination are received.

Please send all reference letters to:
The Honorary Degree Committee at Utica University
1600 Burrstone Road
Utica, NY 13502-4892

Nominee Information
Name of Nominee *
Proposed Award *
Present Position *
Relationship to Utica University
Support Statement if not currently related to Utica University
Street Address *
City *
State *	Alabama Alaska Alberta American Samoa Arizona Arkansas Australian Capitol Territory British Columbia California Canal Zone Colorado Connecticut Delaware District of Columbia Federated States of Micronesia Florida Foreign State Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Marshall Islands Maryland Massachusetts Michigan Military - Americas Military - Europe Military - Pacific Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New South Wales New York Newfoundland Newfoundland and Labrador Norfolk Island North Carolina North Dakota Northern Mariana Islands Northern Territory Northwest Territories Nova Scotia Ohio Oklahoma Ontario Oregon Palau Pennsylvania Prince Edward Island Provence of Quebec Puerto Rico Quebec Queensland Rhode Island Saskatchewan South Australia South Carolina South Dakota Tasmania Tennessee Texas Utah Vermont Victoria Virgin Islands Virginia Washington West Virginia Western Australia Wisconsin Wyoming Yukon Territory
Zip Code *
Email Address
Land Phone
Mobile Phone
Fax
Nominee Education
Nominee Awards
Nominator Information
Nominated By
	Utica Faculty
Address *
City *
State *	Alabama Alaska Alberta American Samoa Arizona Arkansas Australian Capitol Territory British Columbia California Canal Zone Colorado Connecticut Delaware District of Columbia Federated States of Micronesia Florida Foreign State Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Marshall Islands Maryland Massachusetts Michigan Military - Americas Military - Europe Military - Pacific Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New South Wales New York Newfoundland Newfoundland and Labrador Norfolk Island North Carolina North Dakota Northern Mariana Islands Northern Territory Northwest Territories Nova Scotia Ohio Oklahoma Ontario Oregon Palau Pennsylvania Prince Edward Island Provence of Quebec Puerto Rico Quebec Queensland Rhode Island Saskatchewan South Australia South Carolina South Dakota Tasmania Tennessee Texas Utah Vermont Victoria Virgin Islands Virginia Washington West Virginia Western Australia Wisconsin Wyoming Yukon Territory
Zip Code *
E-mail *
Phone *
Fax
Support Statement
Nominator's Brief Statement of Support *