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Alumni Hall of Fame Nomination Form

2010 UCLA School of Public Health Alumni Hall of Fame Nomination Checklist

Nominations must be submitted in English and must include the following:

  • Name, Occupational Address, Phone, Fax, and Email of nominee
  • Name, Occupational Address, Phone, Fax, and Email of nominator
  • Curriculum Vitae and Bibliography of significant publications of nominee
  • A Narrative Statement describing the nominee's qualifications for the Award.
  • A Proposed Citation - limit to 1 or 2 sentences

The 2010 Alumni Hall of Fame nomination categories are:

  • The Lester Breslow Lifetime Achievement Award  
    • The Lester Breslow Lifetime Achievement Award recipient should embody the following:
        • Innovation
        • Entrepreneurship
        • Community Service
  • Young Alumnae/us Achievement: (graduate in the past 7 yrs.)
    • The Young Alumnae/us Achievement recipient should embody the following:
        • Leadership in public health community
        • Entrepreneurship
        • Community Service
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For more information please contact Megan Aubrey:
Phone: (310) 825-5119
Email: maubrey@support.ucla.edu

Deadline is Monday, December 14, 2009.
Nominations can be submitted to Megan Aubrey via:
1. Email: maubrey@support.ucla.edu
2. Campus mail: 16-080 CHS, Box 951772
3. U.S. Mail: UCLA School of Public Health
Office of Alumni Affairs 16-080 CHS, Box 951772
Los Angeles, CA 90095

UCLA SPH Distinguished Alumni