Distinguished Alumni Award

Nominee Information

Nominations must be submitted to the college by March 1, 2019.

Name*

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone

Email

Employer

Year of Graduation from FVCC

Degree/Certificate Earned

Additional Degrees Earned / Additional Education

Describe the leadership and career achievements of the nominee.

Describe the philanthropic and community service achievements of the nominee.

List any honors and awards the nominee has received.

File

I certify that the information on this nomination form is accurate to the best of my knowledge.*

True

Nominator Information

Name*

First Last

Address

Street Address City State ZIP Code

Phone*

Email*

Graduate of FVCC*

Yes
No

Year

Degree/Program

The committee may, at its discretion, check references, including academic records and accomplishments, of the nominees. Relevant information about award candidates and their nominators may be made public through both electronic and print news releases, public announcements, college publications, website and internal campus communications. Releases may include, but are not limited to, nominees’ names and hometown information, quotations from the nominators’ essays, nominees’ employers and lists of achievements.

Name

This field is for validation purposes and should be left unchanged.

Alumni & Donors

Have Questions?

Online Nomination Form

Nominee Information

Nominator Information