SCSU AA Board of Directors Nomination Form

Southern Connecticut State University Alumni Association Board of Directors Nomination Form

Spring 2026
You can nominate a fellow alumnus, or yourself.

Nominating Yourself: All of the fields are required.

Nominating Someone Else: Some of the fields are required, but you are encouraged to fill in as much information as possible for us to verify the nominee's status as an alumnus.
Who are you nominating?*

MyselfSomeone else
Please fill in your information below

(if you are nominating yourself)
Your Name*

First NameMiddle NameLast Name
Your Year of Graduation*
Your Student ID
(refer to e-mail for Student ID)
Your Email*
Your Cell Phone Number*

Area CodePhone Number
Your Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Your Additional Comments (provide brief rationale for why you are nominating yourself)
Please fill in the information of the person you are nominating
Name of nominator*

First NameMiddle NameLast Name
Name of person you are nominating*

First NameMiddle NameLast Name
Their Year of Graduation
Their Cell Phone Number*

Area CodePhone Number
Their Email*
Additional Comments (provide brief rationale for why you are nominating this individual)
This nomination form must be submitted no later than Friday, April 10th, 2026 at 11:59 p.m.

By submitting this form, you consent to a rudimentary background check (i.e. alumni status of the submitter and nominee). All nominations will be subject to a background check and verification of eligibility.

Cell phone and email are required, as we have to contact nominees - and is a requirement for board members.
Should be Empty:

Southern Connecticut State University Alumni Association Board of Directors Nomination Form

Please fill in your information below

Please fill in the information of the person you are nominating