Medallion of Merit Nomination

Nominee name(Required)

Nominee phone

Nominee email

Nominee class year(s), if applicable

Nominee employer

Nominee job title

Wake Forest student activities, if applicable:

Wake Forest volunteer involvement, if applicable:

Civic and volunteer accomplishments:

Professional accomplishments:

How does the nominee embody Pro Humanitate values?

How does the nominee embody Pro Humanitate values?

How has the nominee contributed to the University’s mission by advancing the education and personal growth of Wake Forest students?

Additional information about why the nominee should receive the Medallion of Merit:

Your name(Required)

Your connection to Wake Forest (select all that apply)(Required)

Alumnus/Alumna

Current or former faculty

Current or former staff/administrator

Wake Forest parent

Current or former University Trustee

Other Wake Forest board or council member, current or former

Other

Your address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Your phone(Required)

Your email(Required)

Your class year(s), if applicable

Founders Day