Nomination Form

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6300 Alderson St.
Weston, WI  54476

(715) 359-4221
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D.C. Everest Distinguished Alumnus
Nomination Form

If you know of an Alumnus who has excelled in his/her profession and/or made significant contributions to the community, our state or our nation please fill out the nomination form below and let us know. Annually we select two or three Distinguished Alumnus and present our award and recognition during Homecoming activities.

Nominee Information

Name of Nominated Person
Year of Graduation
Street Address
City  
State
Zip Code 
Phone Number
E-mail Address
Nominee's Current Title
(or Title before Retirement)

Your Information

Your Name
Street Address
City
State
Zip Code
E-mail Address
Home Phone (include area)
Work Phone (include area)
Please give us as much information as possible as to why you feel this person should receive the Distinguished Alumnus Award. Feel free to attach additional information. Please list any significant contributions.
Job Related
Education
Community Service
Additional
 

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(715) 359-4221   |  6300 Alderson Street  |  Weston, WI 54476
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