INDIAN HILLS COMMUNITY COLLEGE FOUNDATION 2018
Outstanding Service or Alumnus Nomination Form
Nominee: Phone:
Address:
City: State: Zip:
Category: ___ IHCC Employee ___ Lay Citizen ___ IHCC Retiree ___Alumnus
Please provide Alumnus’ information (if known):
Student of: ___IHCC ___Iowa Tech ___Centerville Junior/Community College ___ Ottumwa Heights
Approximate year of last attendance: ____________ Program of Study: _______________________
Please identify below the specific characteristics and qualities of your nominee that make him or her
eligible for this award. Specific examples are very helpful to the reviewers. You may type your summary
on a separate sheet and attach it to this nomination.
Nominator: Phone:
State: Zip:
Address:
City:
Please return your completed nomination form to the IHCC Foundation
Office by July 2, 2018 by emailing alison.hite@indianhills.edu. If you
have any questions please call the Foundation Office at 641-683-5101.
