Beberman Nomination Form

Max Beberman Distinguished Alumni Award Nomination Form:

The Max Beberman Distinguished Alumni Award is presented by the University of Illinois Laboratory High School as the highest honor bestowed upon an alumna/us by the School. The award was founded in 1985 to recognize alumni who have enhanced the reputation of the school by distinguishing themselves in their careers and have made significant contributions to their community, state and nation through professional service, public service and civic activities, or in their service to Uni High.

Award Criteria
• Nominee must be a graduate or attendee of the University of Illinois Laboratory High School
• Nominee must have made significant contributions to the school, their community, state or nation through professional service, public service and/or civic activities, or of service to the school.
• Nominee must be prepared to be a key speaker at the school Gala in April.

Selection Process
Nominations are reviewed annually during the fall semester and honorees are selected by a committee convened by the School director. The award is presented at the Uni Gala is April. To submit a nomination, please provide the information as described in this form. The nominator must provide all materials pertinent to the nomination.

1. Nominator Name:

2. Nominator Preferred Phone Number:

3. Nominator Preferred Email Address:

4. Nominator Relationship to the Nominee:

5. List of endorsements (preferred but optional):

6. Nominee Name:

7. Nominee Mailing Address:

8. Nominee Preferred Phone Number:

9. Nominee Preferred Email Address:

Please provide thoughtful and detailed support for your candidate.

10. Honors, accolades, service, professional involvement (list all that apply):

11. How does the nominee’s work and/or accomplishments reflect the value of her/his Uni experience:

12. List significant achievements the nominee has made to the School, their profession, and/or to the greater community through public service or as a volunteer:

13. Express your reasons why this individual should be presented the Max Beberman Outstanding Alumni Award:

14. Provide the nominee’s resume, vitae and other biographical information. (Supporting articles and letters of recommendation are accepted)

Click Submit below or you can use US Mail to:

University of Illinois Laboratory High School
MC-254
Advancement Office (Attn: Beberman Award)
1212 W Springfield Avenue Urbana, IL 60801

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Beberman Nomination Form

Beberman Nomination Form

Max Beberman Distinguished Alumni Award Nomination Form:

1. Nominator Name:

2. Nominator Preferred Phone Number:

3. Nominator Preferred Email Address:

4. Nominator Relationship to the Nominee:

5. List of endorsements (preferred but optional):

6. Nominee Name:

7. Nominee Mailing Address:

8. Nominee Preferred Phone Number:

9. Nominee Preferred Email Address:

Please provide thoughtful and detailed support for your candidate.

10. Honors, accolades, service, professional involvement (list all that apply):

11. How does the nominee’s work and/or accomplishments reflect the value of her/his Uni experience:

12. List significant achievements the nominee has made to the School, their profession, and/or to the greater community through public service or as a volunteer:

13. Express your reasons why this individual should be presented the Max Beberman Outstanding Alumni Award:

14. Provide the nominee’s resume, vitae and other biographical information. (Supporting articles and letters of recommendation are accepted)

Click Submit below or you can use US Mail to:

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