Western Technical College Distinguished Alumni Award

Nomination Form

Eligibility

Nominees must have graduated from Western a minimum of five years ago with an associate degree or technical diploma, and are not current members of the Western Alumni Association Board.

Criteria

The following criteria will be considered in the selection of the award recipient:

• Personal growth and achievement
• Professional achievement
• Community service
• Leadership
• Service to Western Technical College

The recipient will be presented their award at commencement and provide an acceptance speech.

Please verify the information below is correct and then submit.

Nominee Information

Name (required)

Job title

Employer

Home address

Work phone

Home phone

Email

Graduation year/program

Additional education/degree(s)

Nominator Information

Name (required)

Relationship to nominee

Daytime phone

Email (required)

Additional Information

How does this nominee meet the above criteria?

What other characteristics does this person possess that demonstrates why they are deserving of this award?

Additional documents and recommendations are encouraged and can be sent to:

alumni@westerntc.edu