Alumni Award Nomination Form

Awarded to a Central Piedmont Community College graduate who has:
• demonstrated community/professional involvement, social responsibility and impact.
• acquired scholastic and learning skills that have led to continued personal and educational growth.
• improved his or her economic status and social capital as a result of attending Central Piedmont Community College.
• invested in the lives of others and is seen as a role model.
• graduated within the last 10 years (Young Alumni Award of Excellence only).

The selected award recipients will be presented the award at the college's Commencement on Thursday, May 14, 2020, at 10 am. Attendance at graduation is preferred. Political candidates may not be selected or honored in a year in which they are actively pursuing election or re-election.

If you have an issue with the online form and are unsure if it has submitted, please download the Word document version of the nomination form and email to christa.newkirk@cpcc.edu.
* Indicates required field
Please select the award for which you are submitting a nomination. *

Nominator Contact Information

Nominator's First Name *
Nominator's Last Name *
Nominator's Email *
Nominator's Phone *

Nominee Information

Nominee's First Name *
Nominee's Last Name *
Nominee's Email *
Nominee's Phone Number *
Nominee's Current Profession/Area of Expertise *
Approximate Graduation Year(s) *
Rationale for Nomination (500 word maximum) *

Additional Information

Please upload any documents that may supplement and/or support your nomination.
Support Document #1
Support Document #2