Alumnus/Alumna of the Year Award Nomination Form

Information about the Nominee

Name	*
School and Class Year
Degree Earned at Bethel
Home Phone (with area code):
Email

Why is the nominee worthy of this honor?

How does the nominee live out Bethel’s values: we are Christ-followers, character-builders, truth-seekers, learners, reconcilers, salt and light, world-changers.

Nominator Information

Name	*
Daytime Phone (with area code)	*
Evening Phone (with area code)
Email

References (References are crucial to the selection process. Please list name and address of individual(s) who could provide additional information about this nominee. References from a variety of sources, i.e.: civic, community, church, professional, personal, etc., are helpful.)

Reference #1

Name
Address
City
State
Zip Code
Phone
Email

Reference #2

Name
Address
City
State
Zip Code
Phone
Email

Reference #3

Name
Address
City
State
Zip Code
Phone
Email