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Hall of Distinction
Hall of Distinction Nomination Form
Arkansas Tech Hall of Distinction Nomination Form
Arkansas Tech Hall of Distinction Nomination
Arkansas Tech University Hall of Distinction
Nomination Form
Click here for a printable application.
The following Hall of Distinction Nominee was nominated by:
Your First Name
"Your First Name" is required.
Last Name
"Last Name" is required.
Primary E-mail
Email
"E-mail" is required.
Confirm
"E-mail" confirmed text is required.
Emails do not match!
"E-mail"needs to contain a valid entry.
Your password must have
each of the above components
and be at least 12 characters.
Does Not Pass
Low
Moderate
Secure
Very Secure
Re-type your password.
Re-type your email.
Please verify your input by typing it again.
Passwords do not match!
Emails do not match!
Inputs do not match!
Passwords match!
Emails match!
Inputs match!
Address
"Address" is required.
Phone Number
"Phone Number" is required.
Relationship to Nominee
"Relationship to Nominee" is required.
Person you are nominating for the Hall of Distinction:
First Name
"First Name" is required.
Last Name
"Last Name" is required.
Year graduated or attended
"Year graduated or attended" is required.
Address
"Address" is required.
Home Phone
"Home Phone" is required.
Work Phone
"Work Phone" is required.
Email Address
"Email Address" is required.
Major
"Major" is required.
Degree
"Degree" is required.
Award Categories:
Please indicate the award for which you are nominating the person. Check only one option on the menu, please.
Please indicate the award for which you are nominating the person. Check only one option on the menu, please.
Distinguished Alumnus/Alumna
Distinguished Service Award for Alumni
Distinguished Young Alumnus/Alumna
Distinguished Service for Non-Alumni
Distinction in Intercollegiate Athletics
"Please indicate the award for which you are nominating the person. Check only one option on the menu, please." is required.
Nominee Association with Arkansas Tech:
Nominee association with Arkansas Tech University, if not an alumna/alumnus (for Distinguished Service Award only)
Nominee Sports Afiliation with Arkansas Tech:
Nominee Sports affiliation with Tech and years involved (for Distinction in Intercollegiate Athletics only)
Employment History/Positions Held:
Employment History/Positions Held: Describe the nominee's professional accomplishments including work history, directorships and offices held, professional organization memberships, and board appointments.
"Employment History/Positions Held: Describe the nominee's professional accomplishments including work history, directorships and offices held, professional organization memberships, and board appointments." is required.
Community Service & Service to Arkansas Tech University:
Community Service & Service to Arkansas Tech University: Describe the nominee's commitment to their community and to Arkansas Tech. Please list community board appointments, civic organizations and church affiliations, and other community or volunteer information.
"Community Service & Service to Arkansas Tech University: Describe the nominee's commitment to their community and to Arkansas Tech. Please list community board appointments, civic organizations and church affiliations, and other community or volunteer information." is required.
Awards & Recognition:
Awards & Recognition: Describe any awards or recognition the nominee has received, including those related to his or her profession or community service.
"Awards & Recognition: Describe any awards or recognition the nominee has received, including those related to his or her profession or community service." is required.
Family & Additional Information:
Family and Additional Information: Use the following space to give any additional information you deem noteworthy about the nominee. Mail or email additional pages, if needed.
"Family and Additional Information: Use the following space to give any additional information you deem noteworthy about the nominee. Mail or email additional pages, if needed." is required.
Submit any extra documentation here:
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