Withrow Nomination Form

WITHROW HIGH SCHOOL WHO’S WHO GALA - ALUMNI AWARDS NOMINATION FORM

Withrow High School has a rich heritage of producing outstanding alumni. We are pleased to recognize these distinguished individuals. We would appreciate nominations from our alumni and friends. Please submit your nominee’s information using the attached criteria.

Send your completed nomination form to: Withrow Alumni, Inc. P.O. Box 8186 Cincinnati, OH 45208 Attn: Who’s Who Gala - Alumni Awards

Submit copies of magazine articles, resume, photo, etc. to support this nomination. Our goal is to honor our alumni for outstanding achievement and/or service to Withrow High School, the Alumni Association, their communities, and/or their professions. There will be 10 award categories which will be awarded on an annual basis.

Please submit nominations on or before March 4, 2016 for the 2016 Annual Alumni Awards Gala. Nominations are easy. Read the attached criteria of the awards category and choose the category that you believe best fits your candidate. Complete the form and provide one letter of support for consideration of your nominee. Be certain that all materials are complete. Please note that awardees are requested to attend the Alumni Awards Gala on Sunday, April 17, 2016.

I NOMINATE______(Include maiden name if applicable)

HOME ______Street City State Zip

______Phone Fax Email

BUSINESS______Title Business Name

______Street City State Zip

______Phone Fax Email

CATEGORY:  PLEASE MAKE YOUR SELECTION Distinguished Government Service Award Distinguished School Historian Distinguished Entrepreneur of the Year Distinguished Humanitarian Award Distinguished Eye of Tiger Award Distinguished Alumni Band Member Distinguished Clergy or Religion Award Distinguished Medical Field Award Distinguished Educational Field Award Distinguished Recent Graduate Award

Nominators Signature______Phone______

Print name______Email______

Nominations MUST be received by March 4, 2016