NOMINATION FOR THE

TRITON ATHLETIC AWARD

In celebration of its historic athletic past, Iowa Central Community College is proud to announce the creation of the Triton Athletic Award. Its purpose is to honor significant contributions of former Triton athletes, coaches, administrators, and supporters to the success of Eagle Grove Junior College, Webster City Junior College, Fort Dodge Junior College, and Iowa Central Community College athletics. Up to five awards will be granted annually. (Current members of the faculty, staff, board of directors, and award committee members are ineligible to receive this award.)

[PLEASE TYPE]

Name

Home address

Home phone Cell Phone

Business name (or Profession/Life’s Work)

Business address

Position title Daytime phone

E-mail Fax

Degree(s) earned from ICCC (list degree/curriculum/year)

Degree(s) earned from other institutions (list degree/curriculum/year/institution)

SELECTION CRITERIA:

Please follow the nomination format closely. Please list applicable information in each of the following categories, and attach two additional letters of recommendation. Additional attachments or information other than those requested below will not be considered in the selection process.

  1. Nominator’s summary detailing why this person should be chosen for this award. Please refer to the criteria listed on the award form.

Name of nominator

Daytime phone Cell: E-mail

Home address

Business name/title

Business address

Signature of nominator Date

RETURN NOMINATION FORM AND SUPPORTING MATERIALS BY AUGUST 15th to: Iowa Central Alumni Association, Attn: Distinguished Awards Committee, Iowa Central Community College, One Triton Circle, Fort Dodge, IA 50501 or fax to 515-576-7207. Questions? Please call Associate V.P., of Development & Alumni Relations, Laurie Hendricks at 800-362-2793, Ext. 1145 (locally at 515-574-1145), or send e-mail to .

This information is requested to select individuals for recognition. No persons outside the college are routinely provided this information. Excerpts from the nomination and supporting letters may be used for publicity or in the printed program for award winners. (4-10-12)