Outstanding Alumnus Award Nomination Form Please complete this form providing as much of the information as possible. Recipients are selected on an annual basis; nomination forms are due on or before March 1st .Date of Nomination:* MM slash DD slash YYYY Alumni Award Category*Outstanding Veteran AlumniOutstanding AlumniDistriguished Young AlumniOutstanding Faculty/StaffNominee's InformationNominee* First Last Nominee's Home Address: Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Nominee's Phone NumberProgram/Year Graduated Current Employer Position Business Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Business TelephoneNominator's Name First Last Nominator's Phone NumberNominator's Email Address In what capacity do you know the nominee? (Friend, Co-worker, etc.) How did you hear about the Outstanding Alumnus Awards? How has this person shown growth, achievement and leadership in his or her personal and professional life since graduation? (e.g., career achievements, obstacles overcome, etc.)How has this person demonstrated commitment and service to others through contributions of time, talents or treasure? (e.g., community service, service clubs, church, volunteerism, etc.)(Alumnus Awards only) How has this person shown his or her support of North Central Kansas Technical College (NCK Tech) since graduating? (e.g., financial, board representative, advocacy, volunteerism, support/employment of graduates, etc.)(Faculty/Staff Award only) What is your favorite memory of this faculty/staff member?NameThis field is for validation purposes and should be left unchanged. Δ
