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Nomination Form

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An Honorary Degree, or Doctor of Science, honorus causa, is awarded by Clarkson University, usually at Commencement, to a limited number of individuals whose achievements deserve special recognition by the higher education community. Generally an individual has made a significant contribution to their profession, society, and humankind in general, and is deserving of public recognition for their efforts. An honorary degree is awarded in the belief that graduates should share their Commencement with several individuals who, by their accomplishments, have demonstrated extraordinary leadership, service, scholarship, and citizenship. Sometimes an individual has made a specific contribution to the University, usually in the form of distinguished service to Clarkson University. In addition to the form below, all nominations require a second letter of support. Please have the second nominator send a letter of support to or Honorary Degree Nominations, Clarkson University, Box 5500, Potsdam, NY 13699. Note that by policy we do not accept posthumous nominations, family nominations or self-nominations

printable form (* Signifies a mandatory field)

Full Name of Nominee*
Birthplace Birthdate
Home address
City State Zip
Business address*
City* State* Zip*
Spouse or Partner (include maiden name, if applicable; write "none" if none.)
Children (Names):
College/University *
Degree(s) and Year(s) of Graduation*
Professional Accomplishments:*
(Demonstrating eminent achievement in scholarship or creativity)
Present Occupation*
Special Accomplishments Throughout Career*
Attributes of Character & Esteem (altrusitic endeavors)*
Public Service– *
Demonstrating high distinction in service to humanity. May include community, church, civic & public service.
Honorary Degrees the candidate has received and institution from which conferred.
Phone number* E-Mail*