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Distinguished Service to Keystone

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Keystone College Award Nomination Form
Distinguished Service to Keystone
(Due in the Alumni Office by April 15th of the current year)

Description: This award is presented by the Alumni Association each year for outstanding loyalty and service to the College.  This award is presented to a person who has shown significant, long-standing commitment and dedication to Keystone. 

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                      Nominee Information:

Name:

***   Class Year (if applicable):
Address: ***
City: ***State: ***Zip: ***
Daytime Phone Number:

Email:

Degree(s):

Employer:

Employer Address:
City: State: Zip::

Please answer the following questions

1. How do you believe the candidate best exemplifies loyalty to the College? Are there significant examples?

2. Did their commitment make a difference in the direction of Keystone College?  Are there any long-term affects as a result?

3. Why do you think this person should be honored with an award?

4. Please add any other supporting information.

 

Nominator contact information

Nominator's Name: ***     Class Year (if applicable):
Home Address: ***
City: ***State: ***Zip:
Daytime Phone Number:
E-mail Address:
   
Validate Image:  ***