Alumna/Alumnus of the Year Award Nomination

Nominee Information

Name of Nominee:*

Class:*

Present Address:*

City:*

State:*

Zip:*

Phone*

Honors or Awards:*

Year Attended: West Virginia State University*

Year Graduated:*

Is Nominee:*

Resume: Include the following if appropriate: Career Achievements and Community Service

What Contribution has the nominee made to WVSU and the WVSU National Alumni Association?

Include the following if appropriate: Life Member of WVSUNAA, Member of WVSUNAA, Member of Local Chapter, Member of President’s Circle, Attends National Conferences (include dates), Attends Homecoming (include dates).*

Nominated by

Nominator Name:*

Year Graduated:*

Address:*

City:*

State:*

Zip:*

Phone:*

Basis for Nomination

Basis for Nomination:*