TMAA OUTSTANDING ALUMNUS AWARD & LIFETIME ACHIEVEMENT AWARD NOMINATION FORM

NOMINATOR INFORMATION

First Name

Last Name

Confirm email

Daytime Phone Number

Relationship to Tulane

Alumnus/Alumna

Faculty/Staff

NOMINEE INFORMATION

First Name

Last Name

Nominee Tulane School of Medicine Graduation Year (if known):

Award Choice:

Outstanding Alumnus Award

(alum must be at least 10 years past graduation)

Lifetime Achievement Award

(2026 50th reunion celebrants only/alumni from the class of 1976

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