THE 2023 LEGACY OF LEADERS ALUMNI AWARDS

OFFICIAL 2023 LEGACY OF LEADERS ALUMNI AWARDS NOMINATION FORM

THE NATIONAL BLACK COLLEGE ALUMNI HALL OF FAME FOUNDATION, INC.
The National Black College Alumni Hall of Fame honors the legacy of alumni leaders, alumni chapters and national alumni associations who make tremendous - often times uncelebrated, unsung and unappreciated - contributions to their institution. In this regard, we are seeking nominations from college chancellors/presidents, alumni affairs directors and alumni association leaders. The winning individuals or chapters will have demonstrated leadership qualities of integrity and trustworthiness, as well as, possess the ability to communicate a vision, and lead others to take effective action to achieve a goal. They will have a track record of having made a positive impact on their Alma Mater and/or their alumni association, as well as having improved the quality of life in their community.

Only Institution Presidents or Chancellors, National Alumni Association or Chapter Presidents, and Institution Alumni Directors are authorized to submit nominations.

Please submit completed nominations to Merral Jackson via email at mjackson@twd-inc.net or via mail to The National Black College Alumni Hall of Fame Foundation, Inc. at

P.O. Box 42118, Atlanta, Georgia 30311-9002

ALL NOMINATIONS ARE DUE BY July 30, 2022
I/WE NOMINATE:

PrefixFirst NameMiddle NameLast NameSuffix
In the category of:

Distinguished Alumnus of the YearSmall Alumni Chapter of the YearNational Alumni President of the YearLarge Alumni Chapter of the YearAlumni Director of the YearNational Alumni Association of the Year

NOMINATING INSTITUTION
Institution
President/Chancellor
National Alumni President
Alumni Director
Address

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number

Area CodePhone Number
Email
example@example.com
Fax

Area CodePhone Number

NOMINEE'S INFORMATION

(Include a Bio and Photo of Nominee)
Name of Nominee

First NameLast Name
Address

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number

Area CodePhone Number
Fax

Area CodePhone Number
Email
example@example.com
Occupation/Profession

REASON FOR NOMINATION

Please attach a 400-500-word essay detailing reason (s) for nomination.
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NOMINATOR'S INFORMATION
By signing my name herewith, I hereby certify that this nomination is endorsed by the President/Chancellor of this institution, and s/he has given authorization to submit:
Name of Nominator

First NameLast Name
Title
Email
example@example.com
Phone Number

Area CodePhone Number
Date

MonthDayYear
Date
Signature

Clear
Should be Empty:

OFFICIAL 2023 LEGACY OF LEADERS ALUMNI AWARDS NOMINATION FORM

NOMINATING INSTITUTION

NOMINEE'S INFORMATION

REASON FOR NOMINATION

NOMINATOR'S INFORMATION