Arkansas Tech Hall of Distinction Nomination

Arkansas Tech University
Hall of Distinction
Nomination Form

Click here for a printable application.

The following Hall of Distinction Nominee was nominated by:

Your First Name Required Field

Last Name

Primary E-mail Required Field

Address

Phone Number Required Field

Relationship to Nominee Required Field

Person you are nominating for the Hall of Distinction:

First Name Required Field

Last Name

Year graduated or attended Required Field

Address

Cell Phone Required Field

Email Address Required Field

Major

Degree

Award Categories:

Please indicate the award for which you are nominating the person. Check only one option on the menu, please. Required Field

Please indicate the award for which you are nominating the person. Check only one option on the menu, please. Distinguished Alumnus/Alumna
Distinguished Alumni Service
Distinguished Young Alumnus/Alumna
Distinguished Service for Non-Alumni

Nominee Association with Arkansas Tech:

Nominee association with Arkansas Tech University, if not an alumna/alumnus (for Distinguished Service Award only)

Nominee Sports Afiliation with Arkansas Tech:

Employment History/Positions Held:

Employment History/Positions Held: Describe the nominee's professional accomplishments including work history, directorships and offices held, professional organization memberships, and board appointments. Required Field

Community Service & Service to Arkansas Tech University:

Community Service & Service to Arkansas Tech University: Describe the nominee's commitment to their community and to Arkansas Tech. Please list community board appointments, civic organizations and church affiliations, and other community or volunteer information. Required Field

Awards & Recognition:

Awards & Recognition: Describe any awards or recognition the nominee has received, including those related to his or her profession or community service. Required Field

Family & Additional Information:

Family and Additional Information: Use the following space to give any additional information you deem noteworthy about the nominee. Mail or email additional pages, if needed. Required Field

Submit any extra documentation here:

Arkansas Tech University Hall of Distinction Nomination Form