Leaders in Service Hall of Fame Nomination

Nomination Ballot

Deadline for Nominations is September 1st.
Person being nominated: (Southwestern College Alumni or Friend of SC only ) *

First Name Last Name
This nominee is a:

Southwestern College Alum Friend of Southwestern College
Years attended SC:
Years involved with SC:
Significant Achievements and Accomplishments of Nominee in the field of Social Sciences (political science, religion, philosophy, leadership, history, anthropology and psychology): *
Your Information
Your Name: *

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

Area Code Phone Number
Address:

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Nomination Date: *

Month Day Year
Should be Empty:

Nomination Ballot