Hall of Fame Nomination Form

Please check the award for which you are nominating.

Alumni Hall of Fame Award - Awarded to a Northeast Iowa Community College graduate who has excelled in personal and professional endeavors beyond graduation. Please include a list of both community volunteer involvement as well as professional activities outside of regular work responsibilities.

Outstanding Retiree Service Award - Celebrates career long achievements, loyalty and dedication to Northeast Iowa Community College and northeast Iowa recognizing those whose dedication, commitment and efforts rise above and beyond expectations.

Please include a statement that identifies the specific characteristics and qualities of your nominee that make him or her eligible for the award. In addition, please provide one letter of recommendation. These requirements can be uploaded through this form as Word or PDF documents. The deadline for applications is August 1.

Name of Nominee:
Maiden Name: (if applicable)
Street Address:
City:
State:
Country:
Zip Code:
Telephone (with area code):
Email:
NICC Campus or Center Attended/Employed with:
Major Area of Study:
Current Employer/Company:
Job Title:
Explanation of Position/Duties:
Letter of Recommendation (PDF or Word Doc):

Nominator Information:

Nomination Submitted by:
Street Address:
City:
State:
Zip Code:
Telephone (with area code):
Email:
Date of Nomination:

Contact Us

Julie Wurtzel
Executive Director of Advancement
wurtzelj@nicc.edu
800.728.2256, ext. 218

Barbara O’Hea
Director of the NICC Foundation
oheab@nicc.edu
800.728.7367, ext. 284