Overall Eligibility

  • Any alumnus/alumna of SIU SOM
  • Sitting members of the Board of Governors are ineligible
  • See below for the descriptions and selection factors for each of the three Distinguished Alumni awards prior to nominating.

Nomination Process

  • Nominations may be submitted by any alumnus/alumna, faculty or friend of the school
  • Self nominations will not be accepted
  • Nominations will only be accepted by submitting the webform below
  • IMPORTANT: We strongly recommend first writing (and saving) your answers to the application questions in a word processing program (i.e. Microsoft Word or Google Docs). This will save your work in case you run into any technical difficulties when submitting this form.

Selection

  • Selections will be made by the Alumni Society Board of Governors Distinguished Alumni Committee and their recommendations will be brought to the full Board for final approval.
  • Each awardee will be asked to give a short 2-3 minute acceptance speech at the SIU SOM Commencement ceremony (held mid-May) in Springfield, IL. They will also be invited to the Harbinger Society dinner two days prior to Commencement.

**About the Awards**

1. Achievement Award

The Distinguished Alumni Achievement Award recognizes alumni who have made outstanding contributions to medicine and distinguished service to mankind.

Selection Factors for Achievement Award

  • Research
  • Teaching
  • Leadership
  • Provision of high-quality medical care
  • Other acts of merit or generosity

2. Service Award

The Distinguished Alumni Service Award recognizes alumni who have made an outstanding commitment to the health and welfare of their patients and their community and for humanitarian activities.

Selection Factors for Service Award

  • Contributions to their local community (or broader area) in a civic, cultural or health care sense
  • Expertise and contribution to the profession of medicine

3. Early Career Achievement Award

The Distinguished Alumni Early Career Achievement Award recognizes alumni (within the first 15 years of their career) who have made significant contributions through clinical service, research, education, patient care, public or professional service and/or administrative leadership.

Selection Factors for Early Career Achievement Award

  • Epitomize the SIU SOM tradition of excellence through exemplary achievement in medical education, research or patient care within 15 years of their medical school training
  • Expertise and contribution to the profession of medicine

 

Below is the webform for submitting a nominee's application for one of the three Distinguished Alumni awards. This webform consists of three parts:
  1. Basic information about the nominee
  2. Justification for why the nominee is deserving of the award
  3. Basic information about you, the nominator

IMPORTANT: We strongly recommend first writing (and saving) your answers to the application questions in a word processing program (i.e. Microsoft Word or Google Docs). This will save your work in case you run into any technical difficulties when submitting this form.

Distinguished Alumni Nomination Webform

Please select the award for which you are nominating
See award descriptions at the top of this page for detailed descriptions of each award.

Nominee Information

What type of SIU SOM alumnus is the nominee?
Nominee's Address
Is the nominee aware you are submitting their name for consideration this year?
If your nominee is not selected this year, would you like them to be considered for the next three years?
Do you wish to remain anonymous to the nominee/awardee?

Nomination Justification

One file only.
256 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.
Maximum 3 files.
256 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.

Nominator Information

Nominator's Address