To nominate someone for Alumnus or Alumna of the Year please print this form, complete the form & attach any additional information about the nominee, and return to the address at the bottom of this form.
EAST CENTRAL COMMUNITY COLLEGE
2008 NOMINATION FOR
ALUMNUS/ALUMNA OF THE YEAR *
Name:______________________________________________ Maiden_____________________________
Years Attended, Graduated EC:___________________________________
Address:________________________________________________________________________________
Phone (w)_________________________________(h)____________________________________________
High School Graduated From:____________________________________ County_______________________
Senior College/University Attended/Graduated From________________________________ Years___________
Work Experience:
Place Position Dates
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Contributions to College/and to Community:______________________________________________________
______________________________________________________________________________________
Professional Affiliations and Honors:___________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Family:_________________________________________________________________________________
Spouse:________________________________________ Maiden Name_______________________
Did spouse attend EC ___ Yes ___ No, If yes, Years Attended/Graduated_________________________
Children & Ages:___________________________________________________________________
Attach additional information, if needed. Name (of Alumnus/Alumna submitting nomination)
Return to: Alumni Association ________________________Maiden___________
East Central Community College Address___________________________________
P.O. Box 129 _________________________________________
Decatur, MS 39327-0129 Phone (h)______________ (w)________________
Ph. 601-635-2111, ext. 327 Years attended/graduated EC__________________
Deadline: July 01, 2008
*Applications are good for two consecutive years. Additional info about nominees is encouraged. Attach info to this form. Selection is based primarily on print materials received.