<%@ include file="/globalInclude.jsp" %> Potomac State College

Distinguished Service Award Nomination Form
>close window WITHOUT submitting


Award Description:

(a) This award is to be made for exceptional service and dedication to Potomac State College and/or its Alumni Association and in excess of service rendered for which remuneration is received.

(b) The award is not restricted to alumni of the college.

(c) The selection of the recipient will be made by an ad hoc committee of Potomac State College, headed by the President of the College. In addition, the committee will consist of the Secretary of Alumni Affairs, the President, the Vice-President, and the Secretary-Treasurer of the Alumni Association and four members to be chosen by the President of the College.

(d) This award need not be given every year, however, more than one award can be given per year. Under special and extreme circumstances, the award may go to the same person more than once.

(e) The person or persons receiving the award should be able to be present at the banquet, or at the discretion of the Awards Committee, another candidate may be chosen, or the award may be omitted altogether.


I hereby nominate the following individual for consideration as a candidate for the Potomac State College Distinguished Service Award:


Candidate Name:
Candidate Street Address 1:
Candidate Street Address 1:
Candidate City:
Candidate State / Province:
Candidate Zip / Post Code:

Please list the individuals’ qualifications:


Nominator Name:
Nominator Street Address 1:
Nominator Street Address 2:
Nominator City:
Nominator State / Province:
Nominator Zip / Post Code:
Nominator Phone Number:


 

 

  © 2003 Potomac State College of WVU | 1-800-262-7332 | 304-788-6820