Hall of Fame Alumni Form

WATERLOO WEST HIGH SCHOOL HALL OF FAME

Nomination Form for West High Alumni

*Please note: In order to complete this application you must copy and paste the information below on a word document.  Print it out and give it  to one of the following:  Academic Dean or The West High Student Services Office located at: West High School, 425 E. Ridgeway Ave., Waterloo, IA, 50702.

*For more information, please contact Beth Wagner, West High Academic Dean, at 433-2700.

Submitted by:

Telephone:

E-mail:

Date submitted:

Nominee:

Business Address:

Home Address:

Telephone:

Year graduated from West High:

High School Accomplishments (Awards, honors, extracurricular activities, leadership positions):

Post-Secondary Education/Training:

Employment (Position, years, description):

Professional Awards, Honor, Achievements:

Community Service/Philanthropy:

Military Service (including years of active duty and honors/awards):

Please describe why this alumnus should be inducted into the West High Academic Hall of Fame. Include all information which you believe will assist the committee in evaluation your nominee.