Distinguished Alumni Award
Nomination Form


After completing this form, please press Submit to e-mail your nomination to the LCC Alumni Association. Or if you prefer, you may type or write your answers on plain paper and mail to:

LCC Alumni Association
200 South 14th Street
Parsons, KS 67357

If you have questions, please e-mail Lindi Forbes at lindif@labette.edu, or telephone the LCC Alumni Association at (620) 820-1212.

Thank you for your help with this important project.


Nominee's Information

    Title:
    First Name: MI:
    Last Name:
    Maiden Name:
    Address:
    City: State: Zip Code:
    Year of LCC
    Graduation:
    Daytime Phone Number (with area code):
    E-Mail:
    Spouse's Name:
    Names & Ages of Children:


    Colleges & Universities Attended:

    Degree(s) and Year(s) Received:

    Employer and Location:

    Job Title/Assignment:

    Previous Employers (include dates, company name, location, title and assignment):

    Memberships & Offices (including professional, religious and civic organizations):

    Community Activities:

    Books or Articles Published:

    Military Service & Responsibilities:

    Other information you wish to share about the nominee:


    Nominator's Information

    Name:
    Address:
    City:
    State:
    Zip Code:
    Daytime Phone
    (with area code):
    E-Mail Address:
       

  • Previous Recipients
  • 2015 Gale Brown
  • 2015 Joe Heppler
  • 2015 Kara McIlvain
  • 2015 Susan Souders
  • 2014 William "Bill" Devine
  • 2014 Jim Orr
  • 2013 Keith Shaffer
  • 2013 Alice Beachner
  • 2013 Sharon Brown
  • 2013 Kanak Patel
  • 2012 Joe Renfro
  • 2012 Louise Holmes
  • 2012 Kenny LaForge
  • 2012 Shirley Chalker
  • 2011 Calum McNeil
  • 2011 Roberta (Adams) Hoffman
  • 2011 Chuck Tredway
  • 2011 James McKinney
  • 2010 Charles "Chuck" Puckett
  • 2010 Joseph A. Smith
  • 2010 Patricia Ann Woodrum
  • 2009 Jim Bishop
  • 2009 Dr. Wanda Maxson-Ladage
  • 2009 Aaron "Skip" Smith
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