Louisiana College Distinguished Alumni Nomination

Distinguished Alumni Nomination Form

Please complete all applicable areas and submit.

Full Name of Nominee *

Please include any title or suffix with nominee's full name.

Maiden Name *

(if applicable)

Telephone Number *

Home Address *

City *

State, zip code *

Email address

Is Nominee an LC alum?

Year of Graduation *

Degree Earned

Personal Information

Please provide as much information as possible.

Spouse's Name

Children's Names

Grandchildren's Names

Career Information

Awards, Recognitions, and Publications

Additional Degrees or Education

Nominated by

Full Name

Home Address *

State, zip code *

Home Telephone *

Business/cell phone

Connection to Louisiana College

Already one of the most decorated players in Louisiana College and American Southwest Conference history, LC... http://t.co/FIjleK5DNI — 1 day 7 hours ago
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