Fillable Student Nominations Form (California State University Channel Islands)

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Student Nominations Form (California State University Channel Islands)

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ALUMNI & FRIENDS ASSOCIATION
Catch the Wave
Alumni & Friends Association Board of Directors
Nomination Form (Student)
Nominees may self-nominate or be nominated by a third party. Nominators: please be sure that
you have complete information for your Nominee and inform the Nominee of your nomination.
The Nominating Committee will not be researching additional information on the Nominee so
complete information is crucial.
Name _________________________________________________________________
Class Standing (must be a junior or senior to serve)_____________________________
Address _______________________________________________________________
City ___________________________________ State _________ Zip Code _________
Home Telephone Number _________________________________________________
E-mail_________________________________________________________________
Name of Nominator (if not self-nominating): _____________________________
Email:
____________Best Phone Number: _____ _____
Name of Reference #1 _____
Email:
Best Phone Number:
Name of Reference #2
Email:
Best Phone Number: ___________
Clear All Form Fields
Brief Description of extra-curricular, service learning or community service activities:
Current GPA:
Other activities, clubs or organizations involved in at CSUCI or off-campus:
Other skills:
Describe why you would like to serve as a member of the Alumni Association Board of
Directors.
Please complete this form and return it to:
Attn: Alumni Relations
California State University Channel Islands
One University Drive
Camarillo, CA 93012
or fax to (805) 437-2716
or email to
alumni.friends@csuci.edu
All completed forms must be to Alumni Relations no later than January 31, 2007.
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Student Nominations Form (California State University Channel Islands)

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Completed 22 July 2020

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