Page 1 of 3
Central Carolina Technical College
Outstanding Alumni Award Nomination
The Outstanding Alumni Award was established by the Central Carolina Technical College Alumni Partnership to recognize and honor
an alumna or alumnus of CCTC or its predecessor institutions (Sumter Area Technical Education Center, Sumter Area Technical
College) who has achieved significant success and recognition for accomplishments. To be considered for the award, a nominee
should meet the following criteria:
1. Earned a degree, diploma or certificate from the college.
2. Earned the respect and trust of colleagues in the nominee’s chosen career field.
3. Achieved success in career field and/or made contributions for the betterment of fellow human beings.
4. Served as a role model for others.
5. Remained committed to the CCTC mission and the college values of excellence, integrity and innovation.
Nominations must be received by April 1 of each year with awards announced at Spring Graduation.
An individual may make more than one nomination.
Please complete the following form and submit it to this address:
Alumni Partnership
CCTC
506 North Guignard Drive
Sumter SC 29150
or email to alumni@cctech.edu
If you have any questions, please contact the CCTC Alumni Partnership at 803-774-6707 or alumni@cctech.edu
----------------------------------------------------------------------------------------------------------------------------------------------------
Nomination Form
(Please type or print with as much information as you can provide.)
Nominee’s Name _____________________________________________________________
(Include maiden name, if applicable and if this is known.)
Year of Graduation from CCTC: _________________ Program:__________________________
Address: ______________________________________________ City: __________________
State: ___________________________________ Zip: _________________________
Home Phone: ________________________ Business Phone: _________________________
e-mail: _____________________________________________________________________
Page 2 of 3
Central Carolina Technical College Outstanding Alumni Award Nomination
Other Education: (Add any other education, including undergraduate and graduate degrees.)
__________________________________________________________________________________________
__________________________________________________________________________________________
_____________________________________________________
Current Profession/Vocation: _____________________________________________________
Employer: _____________________________________________________________________
Name of Supervisor: _____________________________________________________________
Employer Address: ______________________________________________________________
Awards/Honors/Achievements: ____________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Community Service:
_____________________________________________________________________________
______________________________________________________________________________
Please use the space below for any additional information or attach a separate sheet.
Page 3 of 3
Central Carolina Technical College Outstanding Alumni Award Nomination
Your Information (Required)
Name: ______________________________________________________ Date: _____________
Address: _____________________________________________________________________
City: _____________________________ State: __________________ Zip:____________
Phone: ___________________________ e-mail: ___________________________________
Relationship to nominee: ______________________________________________________
Your Signature: ____________________________________________________________________
The information on this sheet will be considered confidential.
Thank you for your nomination.
click to sign
signature
click to edit
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome