About The Nominee:

 

Please note, nominee must have completed at least 30 credits at BC3 and must not be an active BC3 Board, Trustee, or Council member

 

Name of Nominee:

Name while attending BC3:

Address:

City: State:

Zip Code:

Home Phone:

Work Phone:

Email:

BC3 Graduation Year / Date(s) of Attendance:

Degree Earned (if applicable):

Major:

 

Reason for Nomination:

 

What distinguishes the nominee in their profession and/or community service?

 

About You:

Name:

Address:

City: State:

Zip Code:

Home Phone:

Work Phone:

Email:

Relationship to Nominee:

 

Additional Comments/Suggestions:

 

* Enter sequence of characters pictured below

Please click the submit button when you are finished. If you have any questions contact the Alumni Association (information located to the right).