123 Reynolds Alumni Center * Columbia, Missouri 65211 * 800-372-6822 Henry S. Geyer Award for Public Service N O M I N A T I O N The Mizzou Alumni Association invites nominations for the Henry S. Geyer Awards for Public Service to Higher Education. This award recognizes the work of two individuals, one public official and one private citizen, who have made significant positive impacts on higher education and on the University of Missouri. Note: Nominees do not have to be alumni of Mizzou. Please return this form by September 27, 2019, to: Mizzou Legislative Network C/O Mizzou Alumni Association 123 Reynolds Alumni Center Columbia, MO 65211 Or Fax to: (573) 882-5145 Or Email as an attachment to:
[email protected] This nomination is for: public official private citizen Nominator Information: Name of Nominator: Name of organization nominator represents: Mailing Address: City: State: Zip: Phone: E-mail 2019 Geyer Nomination 1 of 4 Nominee Information: Name of Nominee: Mailing Address: City: State: Zip: Phone: E-mail: Please include the following with this nomination form: • A summary describing the nominee’s career accomplishments (no more than one page, single- spaced) • A summary describing how the nominee has contributed to the improvement of higher education and Mizzou (no more than one page, single-spaced) Two additional pages are included for your use in submitting a nomination. Awardees will be selected in the fall of 2019 and presented with their awards at a reception in early 2020 in Jefferson City. PAST RECIPIENTS 2018: Lieutenant Governor Mike Kehoe and Dr. David Russell 2017: Representative Nate Walker and Gary Smith 2016: Senator Dan Brown, Representative Donna Lichtenegger, and M.