Alumni

Rising Star Alumni Award

2020-2021 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 Ed Boston at alumni@supportclark.org or 360.992.2767.
Nominee's Name*
First Last
Nominee's Date of Birth or Age (born in 1984 or later)*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Nominee's Email
Years nominee attended Clark College (e.g., 1998-99)
NOMINEE'S ACCOMPLISHMENTS AND CONTRIBUTIONS
Examples of nominee's exceptional service to the college:
Examples of nominee's exemplary service to the community:
Example of nominee's personal and professional achievements:
ADDITIONAL INFORMATION about nominee
Accepted file types: word, pdf, Max. file size: 50 MB.
(Optional) Attach a document
NOMINATOR'S INFORMATION
Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone (with area code)