Young Alumni Award

YOUNG ALUMNI AWARD

2016 Nomination Form

The Greater Binghamton Chapter Young Alumni Aware is open to all individuals who: - Resided in the chapter area while a student at Penn State or currently resides in our chapter area - Alumni of any Penn State Campus…. Including World Campus - Are 39 years of age or younger.

To nominate an individual for the Greater Binghamton Chapter Young Alumni Award, please provide the following information concerning the nominee:

Nominee’s Name______{P Class Year______Major______

Address______

City______State______Zip______

Home Phone Number______Cell Phone______Home Email______

Business Title______

Company Name______

City______State______

Additional Graduate Study

Year and Degree______College or University______

Nominator(s)______

Address______

City______State______Zip______

Daytime Phone Number______Cell Phone______Email______

The Young Alumni Award is presented to an alumnus who has made outstanding contributions in one or more of the following ways and has not yet achieved the age of 40:

• Exceptional accomplishment in chosen field.

• Exceptional service in local, state or national affairs.

• Exceptional service in support of the advancement and continued excellence of Penn State.

Please list the nominee's accomplishments for each category on this form. Please include a resume or bio with the nomination form. Additional supporting material (press releases, awards, honors, etc.) may be included as well. Nominations are kept on file and considered for the Chapter Young Alumni Award for three years or until they reach 40 years of age, whichever comes first.

Final selection will be made by the Greater Binghamton Chapter Board of Directors

Applications must be received no later than December 15th and mailed to:

Bob Malecki

155 Lewis Rd.

Binghamton, NY 13905.

Nominee:______

Please provide information on the nominee in the following categories. Nominees with

contributions in two or more areas of the criteria will be given preferential consideration.

1. List exceptional accomplishments in business or professional life.

2. List exceptional service in community affairs at local, state, or national levels.

3. List exceptional service to or for the continued excellence of the Greater Binghamton

Chapter and Penn State.