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Louisiana College Distinguished Alumni

Nomination Form

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- NOMINEE INFORMATION -
- General Information -
Full Name of Nominee
Maiden Name (if applicable)
Telephone Number
Home Address
City
State, Zip Code
Email Address
LC Alum?		Yes No
Year of Graduation
Degree Earned
- Personal Information -
Spouse's Name
Children's Names
Grandchildren's Names
- Career Information -

- Civic, Social and Religious Involvement -

- Awards, Recognitions, and Publications -

- Additional Degrees or Education -

- NOMINATED BY -
Full Name
Home Address
City
State, Zip Code
Email Address
Home Telephone
Business Telephone
Connection to Louisiana College

For more information about the Louisiana College Distinguished Alumni award, contact:

Ms. Luana Cunningham
Coordinator of Alumni and Foundation Relations
Telephone: (318) 487-7301
Email: