Alumni Award Nomination Form

Please fill out the form below to submit your nomination.

Mail letters of recommendation and/or additional information to the Alumni Office. This additional documentation will help in the selection process.

Rockford College
Alumni Relations
5050 E. State St.
Rockford, Il 61108-2393

Section 1: Nominee Information
Name of Nominee:
Class Year:
Address:
City: State: Zip:
Daytime Phone:
Home Phone:
E-mail Address:
Employer:
Title/Position:
Section 2: Award Information
Type of Award:
Reason for Nomination:
Recognitions/Civic Accomplishments:
Education/Degree(s):
Service to Rockford College:
Section 3: Family Information
Spouse's Name:
College Attended:
Children:
Section 4: Nominator Information
Nominator's Name:
Daytime Phone:
Home Phone:
E-mail Address: