Southwest Distinguished Alumni Nomination Form Due March 1, 2017

SOUTHWEST HIGH SCHOOL

Distinguished Alumni Nomination Form

– Nominations for 2017 are due on March 1, 2017  --

The Distinguished Alumni Award is a recognition designed to honor alumni of Southwest High School. Honorees are selected for their outstanding contributions to their community, alma mater, or country in their chosen career or community service.

The Distinguished Alumni Award is a new tradition for Southwest, a high school with an outstanding history of excellence. In honoring Southwest High School alumni, we hope to inspire current students to be lifetime learners and community leaders beyond Southwest. This recognition will be bestowed upon alumni who have exhibited or continue to exhibit a diverse array of admirable qualities such as leadership, generosity, integrity, dedication, and creativity and who have shared of their talents via their occupation, special interest or contributions to Southwest.

The Committee will accept up to three nominations per year from any one person.

1. Name of person completing form:______________________________________________ Email:_______________________________________ Phone #:_______________________

Brief explanation of your knowledge of/relationship to nominee: __________________________________________________________________________

2. Name of nominee for Distinguished Alumni Award (include maiden name if applicable): __________________________________________________________________________ Graduation year (if known) / era: ___________________ Living _____ Deceased ________

3. Current contact information for nominee (or next of kin for posthumous awards). The Committee cannot consider a nominee unless this contact information is complete.

Address: ___________________________________________________________________

Phone: ___________________________  Email: ____________________________________

4. Please thoroughly describe the experiences and contributions of the nominee that inspire you to nominate them for this honor. If you are nominating yourself, please include information that will allow the Committee to verify your accomplishments. Please limit the length of your submissions to no more than three pages. ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Please send the completed nomination form to the Southwest Foundation, 3414 W. 47^th St., Minneapolis, MN 55410. The Southwest Foundation will retain all applications on-file for future consideration if a nominee is not selected as a Distinguished Alumni Award recipient the year the nomination is received.