MESA COLLEGE DISTINGUISHEAL
UMNIAWAZD
NOMINATIONFORM
Tobe
consideredfortheSANDIEGOMESACOLLEGEDistinguishedAlumniAward,thefollowingcriteriamustbemetby
thenominee:
1.ThenomineemusthaveattendedSANDIEGOMESACOLLEGE.
2.ProfessionalAchievementandCareerDistinction‐‐Demonstratedsuccesswithintheirch osencareerorfield
ofexper
tise.
3.ServicetoSociety/Com
munitybasedservice
Tonominateapersonforthisaward,please:
1.Completethenomineeinformation
belowascompletelyaspossible.
Nominee’sFullName
MaidenorOtherName
Address
CityState ZIP
Telephone
Email
YearsAttendedMesa
Degree Certificate Unknown
Program/AreaofStudy
Othercollegesattendedanddegree(s)attained:



CurrentOccupation/Title/ProfessionalAffiliations

2.Highlighting(in200words)yournominee’sprofessionalaffiliationsandcommunitybasedserviceandsupportto
MesaCollege.

3.Prepareaonepagestatement(onaseparatesheetofpaper)In250wordsorless,detailyournominee’s
accomplishmentsastheyrelatetohis/herfieldofworkorexpertise.Accomplishmentsandawardsnotrelatedtohis/her
fieldofworkwillbeconsideredassupplementalinformation.
Nominate
dby__

Date
Telephone
EMailAddress
AffiliationtoSanDiegoMesaCollege:
Student Faculty Staff Retiree Other
Instructions:SAVEasapdftoyourfiles
COMPLETEandthesavetheform
EMAILtheformto:lheil@sdccd.edu
or
OR
MAILtheformto: LinaHeil,PublicInformationOfficer
SanDiegoMesaCollege,OfficeA-110
7250MesaCollegeDrive,SanDiego,CA921114998
Questions?Contact:LinaHeil,PublicInformationOfficer,Call6193882759lheil@sdccd.edu