Fine Arts Hall of Fame Nomination - Southwestern College

Nomination Ballot

Fine Arts Hall of Fame
Person being nominated: (Southwestern College alumni or long-time faculty only)*

First NameLast Name
Please select one of the options below. Your nominee is a:*

Southwestern College AlumLong-Time Faculty Member
Graduation Year:
(YYYY)
Years on Faculty:
Significant Achievements and Accomplishments of Nominee:*
Endorsement (check only if endorsing a previous nomination)
Your Information
Your Name:*

First NameLast Name
E-mail:*
Phone Number:*

Area CodePhone Number
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Thank you for taking time to make this nomination. After submitting this electronic form, the selection committee asks that you have two other persons each provide an endorsement of this outstanding individual. Their endorsements may be submitted electronically on this same form (they will select the Endorsement check box in form), or may be mailed to the Director of Alumni Programs, Southwestern College, 100 College Street, Winfield, KS 67156. Either way, be sure to indicate if it is an endorsement for the Fine Arts Hall of Fame nomination.
Nomination Date:*

MonthDayYear
Should be Empty:

Nomination Ballot