Alumni

Outstanding Alumni Awards

2019 Nomination Form

NOMINEE INFORMATION
* Required information. To ensure your nominee receives maximum consideration, please fill in the form as completely as possible. If you have questions or would like a hard copy of the nomination form, please contact Joel B. Munson at alumni@supportclark.org or 360.992.2428.
Full Name*
Address
Street Address Address Line 2 City State ZIP Code
Phone (including area code)*
Email
Current Employer
Title / Position
Address
Street Address Address Line 2 City State ZIP Code
Years attended Clark College (e.g., 1961-1963)
Is nominee a graduate of Clark College?
NOMINEE'S ACCOMPLISHMENTS AND CONTRIBUTIONS
Has provided exceptional services to the college through activities with Clark alumni , volunteer work, financial support or college employment:
Has demonstrated exemplary service to the community:
Has received recognition by community members (i.e., awards, honors):
Has demonstrated personal and/or professional achievements:
NOMINATOR'S INFORMATION
Full Name*
Phone (including area code)*
Email*
Relationship to Nominee*