Gold Blazer Award
Nomination Form
If unknown, write unknown
(To the best of your knowledge, what they earned from our institution):
(Estimate if needed)
If retired, type most recent details and indicate retired.
How has the nominee made a significant impact from service contributions? (Can include contributions to TAMUC, their profession, and/or community.)
What other organizations, groups, or volunteers has the nominee worked with in their service efforts? Has the nominee influenced others in their work?
List any awards, honors, and/or recognitions received:
List characteristics and personal qualities that make the nominee a role model:
Please include a brief statement on why you believe the nominee deserves the award:
Attach the Following: