City State Zip
Employer (name and address if applicable)
Job Title (if applicable)
of the Year Nomination Form
• Nominations must be received or postmarked by Monday, July 27, 2020.
• Nominations can be submitted via email to firstname.lastname@example.org, or mailed to MCC Alumni Association, PO Box 1046, MS #15, Manchester, CT 06045-1046.
Nomination Eligibility and Criteria
• The nominee must have earned an MCC degree or certificate or completed a minimum of 30 credit hours at MCC.
• The nominee will be judged on the following criteria:
• Role Model – Inspiring excellence in others.
• Outstanding Success – Significant career or personal achievements.
• Impact – Demonstrate outstanding contributions to MCC and/or the community through leadership, public service, philanthropy or volunteerism.
• The nominee must agree, if selected as an award recipient, to be present to accept the award at the annual Alumni Dinner and Awards Evening to take place at MCC on
Wednesday, November 18, 2020.
• The nominee must be a person of such integrity and stature that MCC will take pride in their recognition.
• Nominees may self-nominate or be nominated by MCC students, alumni, employees and community members. If self-nominating, at least one current letter of
recommendation must be submitted.
• Nominees remain nominated for two years after receipt of their nomination.
• Recipients will be selected by the MCC Alumni Association Alumni Awards committee by Monday, August 17, 2020.
Relationship to Nominee
First Name MI Last Name MCC Graduation Year (if applicable)
City State Zip
Questions: Call Diana Reid at 860-512-2909 or email email@example.com.
First Name MI Last Name MCC Gradation Year
Degree or Certiﬁcate
Is the nominee aware that you are nominating him/her?