Award Recipient Information Sheet

Please fill out the form below to help us prepare for the Distinguished Awards Celebration. Thank you for all that you've done for the University of Northern Iowa!

Recipient Information

Preferred name to appear on award:

Email Address

I/we will attend the dinner and award presentation at Maucker Union on Friday, November 22, 2024, 5 p.m. - 8 p.m.

Yes

Spouse/Guest Name(s):

Preferred name for your nametag:

I/we will need a hotel room for the following nights

Friday, November 22

Saturday, November 23

I/we would prefer the following type of accommodations:

King

Double

Awardees will be recognized on field at the UNI football game on Saturday, November 23, 2024. You will receive 2 complimentary tickets to watch the game in the UNI president's box. I will need 2 tickets and will attend the football game.

Yes

You may request tickets for the football game for family and friends. Tickets can be purchased for $20 each. Please indicate the number of additional tickets needed:

Please provide a recent photo for news release and the website.

One file only.
768 MB limit.
Allowed types: gif, jpg, jpeg, png.

Please list names and addresses of family, friends, UNI deans, faculty and staff, co-workers, employers and guests to invite to the awards dinner.

Please list any dietary or special needs for the weekend:

Award Recipient Information Sheet

Recipient Information

Recipient Information

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