Sponsor Award Nomination Form

Candidate's First Name
Candidate's Last Name
Candidate's Gender	Male  Female

Candidate's Mailing Address
Address
Address Line 2
City/Town
State/Country	Select OneAlaskaAlabamaArkansasArizonaCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIowaIdahoIllinoisIndianaKansasKentuckyLouisianaMassachusettsMarylandMaineMichiganMinnesotaMissouriMississippiMontanaNorth CarolinaNorth DakotaNebraskaNew HampshireNew JerseyNew MexicoNevadaNew YorkOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVirginiaVermontWashingtonWisconsinWest VirginiaWyomingUS TerritoriesDistrict Of ColumbiaArmed Forces (the) AmericasAlbertaArmed Forces EuropeArmed Forces PacificAmerican SamoaBritish ColumbiaCanal ZoneFederated States of MicronesiaGuamLabradorManitobaMHOntarioMarshall IslandsNew BrunswickNewfoundlandNorthern Mariana IslandsNova ScotiaNorthwest Territories NunavutPrince Edward IslandPalauPuerto RicoQuebecSaskatchewanTrust TerritoriesVirgin IslandsYukon TerritoriesCountriesAfghanistanAfricaAlbaniaAlbaniaPeoples Republic of AlgeriaAmerican SamoaArgentina, SAArmeniaAruba, Neth.AntillesAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbados, W.I.BelgiumBelizeBermudaBolivia SABosnia/HerzegovinaBotswanaBrazilBritish Virgin IslandsBritish West IndiesBulgariaBurkina FasoBurkina-Faso, AfricaBurmaCambodiaCameroon, AfricaCanadaCape VerdeChile SAChinaColombia, SACongoCosta RicaCote D'IvoireCroatiaCubaCuracao, Neth. AntillesCyprusThe Czech RepublicDenmarkDominican RepublicDominica, WIEast AfricaEcuador SAEgyptEl SalvadorEnglandEquador SAEritreaEstoniaEthiopiaFigi IslandsFinlandFranceGambiaRepublic of Georgia, CISGermanyGhanaGreeceGrenada, W.I.Guadeloupe, French West IndiesGuamGuatemalaGuinee, AfricaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyIvory CoastJamaica, WIJapanJerusalemJordanKazakhstanKenyaKoreaKuwaitKyrgyzstanLatviaLebanonLiberia, AfricaLibyaLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaRepublic of MaliMaltaMauritiusMexicoMoldovaMonacoMongoliaMontserrat, W.I.MoroccoMozambiqueMyanmarNamibiaNepalNetherlandsNew GuineaNew ZealandNicaraguaNigeriaNorthern IrelandNorwaySultanate of OmanPakistanPanama Repub.ParaguayPeruPhilippinesPolandPortugalQatarRomaniaRepublic of South AfricaRussia, CISRwandaSouth AfricaSaudi ArabiaScotlandSenegalSerbia-MontenegroSierra LeoneSingaporeSlovak RepublicSlovakiaSouth KoreaSomaliaSpainSri LankaSt. Kitts, W.I.St. Lucia, W.I.St. Maarten N.A.SudanSurinameSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogo, West AfricaTrinidad/TobagoTunisiaTurkeyTurkmenistanU.S. Virgin IslandsUnited Arab EmiratesUnited Arab RepublicUgandaUkraineNorthern IrelandUnited KingdomUruguayUzbekistanVenezuelaVietnamWest AfricaWest GermanyYap IslandsYemen Arab RepublicYugoslaviaZaireZambiaZimbabwe
Zip/Postal Code
Home Phone
Cell Phone
E-mail Address

High School/College Attended
Academic Interest

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State the ways in which this student exemplifies the qualities associated with a Regis College student and why you believe that he or she is a worthy candidate of the Alumni Sponsor Award.

Length of time you've known the nominee	years months

Describe your personal relationship and knowledge of the nominee

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Alumnus' First Name
Alumnus' Last Name
Alumnus' Class

Alumnus' Mailing Address
Address
Address Line 2
City/Town
State/Country	Select OneAlaskaAlabamaArkansasArizonaCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIowaIdahoIllinoisIndianaKansasKentuckyLouisianaMassachusettsMarylandMaineMichiganMinnesotaMissouriMississippiMontanaNorth CarolinaNorth DakotaNebraskaNew HampshireNew JerseyNew MexicoNevadaNew YorkOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVirginiaVermontWashingtonWisconsinWest VirginiaWyomingUS TerritoriesDistrict Of ColumbiaArmed Forces (the) AmericasAlbertaArmed Forces EuropeArmed Forces PacificAmerican SamoaBritish ColumbiaCanal ZoneFederated States of MicronesiaGuamLabradorManitobaMHOntarioMarshall IslandsNew BrunswickNewfoundlandNorthern Mariana IslandsNova ScotiaNorthwest Territories NunavutPrince Edward IslandPalauPuerto RicoQuebecSaskatchewanTrust TerritoriesVirgin IslandsYukon TerritoriesCountriesAfghanistanAfricaAlbaniaAlbaniaPeoples Republic of AlgeriaAmerican SamoaArgentina, SAArmeniaAruba, Neth.AntillesAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbados, W.I.BelgiumBelizeBermudaBolivia SABosnia/HerzegovinaBotswanaBrazilBritish Virgin IslandsBritish West IndiesBulgariaBurkina FasoBurkina-Faso, AfricaBurmaCambodiaCameroon, AfricaCanadaCape VerdeChile SAChinaColombia, SACongoCosta RicaCote D'IvoireCroatiaCubaCuracao, Neth. AntillesCyprusThe Czech RepublicDenmarkDominican RepublicDominica, WIEast AfricaEcuador SAEgyptEl SalvadorEnglandEquador SAEritreaEstoniaEthiopiaFigi IslandsFinlandFranceGambiaRepublic of Georgia, CISGermanyGhanaGreeceGrenada, W.I.Guadeloupe, French West IndiesGuamGuatemalaGuinee, AfricaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyIvory CoastJamaica, WIJapanJerusalemJordanKazakhstanKenyaKoreaKuwaitKyrgyzstanLatviaLebanonLiberia, AfricaLibyaLithuaniaLuxembourgMacaoMacedoniaMadagascarMalawiMalaysiaRepublic of MaliMaltaMauritiusMexicoMoldovaMonacoMongoliaMontserrat, W.I.MoroccoMozambiqueMyanmarNamibiaNepalNetherlandsNew GuineaNew ZealandNicaraguaNigeriaNorthern IrelandNorwaySultanate of OmanPakistanPanama Repub.ParaguayPeruPhilippinesPolandPortugalQatarRomaniaRepublic of South AfricaRussia, CISRwandaSouth AfricaSaudi ArabiaScotlandSenegalSerbia-MontenegroSierra LeoneSingaporeSlovak RepublicSlovakiaSouth KoreaSomaliaSpainSri LankaSt. Kitts, W.I.St. Lucia, W.I.St. Maarten N.A.SudanSurinameSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogo, West AfricaTrinidad/TobagoTunisiaTurkeyTurkmenistanU.S. Virgin IslandsUnited Arab EmiratesUnited Arab RepublicUgandaUkraineNorthern IrelandUnited KingdomUruguayUzbekistanVenezuelaVietnamWest AfricaWest GermanyYap IslandsYemen Arab RepublicYugoslaviaZaireZambiaZimbabwe
Zip/Postal Code
Home Phone
Cell Phone
E-mail Address

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To be completed by student
List the leadership/athletic/school/volunteer/community service activities in which you have been involved. (Please include the time commitment and length of involvement.)
I believe that I am a worthy candidate of the Alumni Sponsor Award because...
What can you bring to the Regis College Community?

NOTE: This award is honorary and is not based on financial need, but will be included if a financial aid package is awarded. Nomination for the Alumni Sponsor Award does not guarantee awarding.