Alumni Association

Alumni Recognition Nomination Form

About You
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*First Name:
*Last Name:
*Email:

Street:

City:
State/Prov.:
Zip/Postal Code:

About the Nominee
*Nominee First Name:
Nominee Maiden Name:
*Nominee Last Name:
Nominee Class Year:
*Award:	Outstanding Alumnus/Award Kenneth J. Shouldice Achievement Award Paul Ripley Award for Young Alumni Dr. Donald and Catherine Finlayson Distinguished Citizen Award Hall of Fame Athletic

Statement of support: Please explain what makes this nominee deserving of the above indicated award. Please include other supporting material you may have, including links to websites. Hard copies may be mailed to: LSSU Alumni Association* Attn: Alumni Recognition Program 650 W Easterday Ave Sault Ste. Marie, MI 49783

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