Fill - Free fillable MESA COLLEGE DISTINGUISHED ALUMNI AWARD NOMINATION FORM PDF form



MESA COLLEGE DISTINGUISHEAL

UMNIAWAZD 

NOMINATIONFORM



Tobe

consideredfortheSANDIEGOMESACOLLEGEDistinguishedAlumniAward,thefollowingcriteriamustbemetby

thenominee:

1.ThenomineemusthaveattendedSANDIEGOMESACOLLEGE.

2.ProfessionalAchievementandCareerDistinction‐‐Demonstratedsuccesswithintheirch osencareerorfield

ofexper

tise.

3.ServicetoSociety/Com

munity‐basedservice

Tonominateapersonforthisaward,please:



1.Completethenomineeinformation

belowascompletelyaspossible.



Nominee’sFullName



MaidenorOtherName



Address

CityState ZIP  

Telephone

Email

YearsAttendedMesa  

 Degree Certificate  Unknown

Program/AreaofStudy



Othercollegesattendedanddegree(s)attained:









CurrentOccupation/Title/ProfessionalAffiliations







2.Highlighting(in200words)yournominee’sprofessionalaffiliationsandcommunity‐basedserviceandsupportto

MesaCollege.



3.Prepareaone‐pagestatement(onaseparatesheetofpaper)In250wordsorless,detailyournominee’s

accomplishmentsastheyrelatetohis/herfieldofworkorexpertise.Accomplishmentsandawardsnotrelatedtohis/her

fieldofworkwillbeconsideredassupplementalinformation.



Nominate

dby__



Date

Telephone

E‐MailAddress

AffiliationtoSanDiegoMesaCollege:

Student Faculty Staff Retiree Other



Instructions:SAVEasapdftoyourfiles

COMPLETEandthesavetheform

EMAILtheformto:lheil@sdccd.edu

or

OR

MAILtheformto: LinaHeil,PublicInformationOfficer

 SanDiegoMesaCollege,OfficeA-110

 7250MesaCollegeDrive,SanDiego,CA92111‐4998



Questions?Contact:LinaHeil,PublicInformationOfficer,Call619‐388‐2759lheil@sdccd.edu





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MESA COLLEGE DISTINGUISHED ALUMNI AWARD NOMINATION FORM

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