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Distinguished Alumni Award Nomination Form

The Distinguished Alumni Award recognizes a graduate from Keyano College who has achieved outstanding accomplishments made in their professional or personal life, in their community, and who have been an inspiration to fellow alumni, current students and the community. This award is given out once in each academic year.

Please complete the information below.

Nominee Information:

* Required information

Full name of nominee

Nominee's address

Nominee's phone number

Nominee's email address

Nominee's title and occupation

Nominee's program and certificate, diploma and/or degree confirmation

Please tell us why you are nominating this individual

Please provide a description of any achievements and/or accomplishments the nominee has made in their career

Please provide a description of any outstanding contributions the nominee has made in their community:

Please note any additional academic accomplishments the nominee has made in their educational career post Keyano College

How does the nominee continue to support Keyano College?

Your full name

Your address

Your phone number

Your email address

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Distinguished Alumni Award Nomination Form

Nominee Information: