CCSU Alumni Association Distinguished Alumni Service Award Nomination Form

CCSU Alumni Association Distinguished Alumni Service Award Criteria

The Distinguished Alumni Service Award is presented to a graduate of Central Connecticut State University (Central Connecticut State College, Teachers College of Connecticut or New Britain Normal School) in recognition of outstanding service to the University or the Alumni Association and to the community, since graduation, and for professional excellence in one’s chosen profession.

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CCSU Alumni Association
Distinguished Alumni Service Award Nomination Form

Nominee Information

Name *
Class *
Home Address *
Home Address (continued)
City *
State *
Zip
Please describe below those activities, achievements or contributions made by the nominee which you believe qualify this person for the award. Please submit as much information as possible.
Service to University
Service to Community
Professional Achievements
Additional important information

Nominator Information

Name *
Home Address *
Home Address (continued)
City *
State *
Zip *
Daytime Phone *
Home Phone *
Email

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