2023 AVES - Faculty Nomination Page - Lane Tech Alumni Association

Date *

FACULTY / TEACHER Name *

First

Middle

Last

FACULTY Title *

FACULTY Email *

FACULTY Phone *

NOMINATED STUDENT Name *

First

Middle

Last

STUDENT Email *

IN WHICH CLASS DO YOU TEACH THIS STUDENT? *

HOW MANY YEARS HAVE YOU TAUGHT THIS STUDENT? *

Special Notes and Comments:

ACKNOWLEDGEMENT *

"YES"

I acknowledge that all information on this nomination is complete, accurate and honestly presented to the best of my knowledge and belief. By clicking on "Yes", I hereby authorize release to the LTAA Scholarship Committee all information in this form. I understand that the LTAA Scholarship Committee will make the final decision on the selection of the scholarship recipient(s) based on the criteria and description of the scholarship.