Outstanding Alumnus Nomination Form

Please supply us with as much of the information as possible when completing this form.

NOMINEE INFORMATION:
Today's Date:
Nominee's Name:
Street Address:
City:
State:	Zip:
Home Phone:
Program/Yr Graduated:
Current Employer:
Position:
Business Address:
Business Phone:
NOMINATOR INFORMATION:
Nominator’s Name:
Phone Number:
Email Address:
In what capacity do you know this nominee (friend, co-worker, etc.)?
How did you hear about the Outstanding Alumnus Award?
PERSONAL/PROFESSIONAL GROWTH:
How has this person shown growth, achievement and leadership in his or her personal and professional life after graduating?


CIVIC ACCOMPLISHMENTS:
How has this person demonstrated commitment and service to others through contributions of time, talents or treasure?


COLLEGE SUPPORT:
How has this person shown his or her support of Minnesota State College-Southeast Technical since graduating?

Minnesota State College-Southeast Technical