WITCC Alumni & Friends

Alumni "Family & Friends" $250 Scholarship Nomination Form

As an alumnus of Western Iowa Tech Community College, you have the opportunity to nominate someone you know for a $250 ‘Family & Friends’ Alumni Scholarship! Simply fill out the information of the person you think would benefit from this scholarship and we will do the rest!

Nominations are due by June 30, 2008, to be considered.

Items in bold are required.
Your Information
First Name:	Middle Initial:
Last Name:
Address:
City:
State/Country:	Zip:
Phone:	(for our internal contact purposes only)
E-mail:	(for our internal contact purposes only)
Year Graduated:	Program of Study:
Nominee's Information
First Name:	Middle Initial:
Last Name:
Address:
City:
State/Country:	Zip:
Phone:	(for our internal contact purposes only)
E-mail:	(for our internal contact purposes only)
Program of Study:	(if known)
How do you know the nominee and how can they benefit from this scholarship?