NOMINATION FOR LEGACY AWARDS

Nomination Form

Category:
Name:
Postal Address:
Email Address:
Contact Number:
Birthdate:
Civil Status:
Gender:
  Zip Code:  

Educational Attainment

Post Graduate (School Attended / Course):
Graduate (School Attended / Course):
College (School Attended / Course):
High School:
Elementary
Career History
Year:
Designation:
Organization
Volunteer Work/ Civic Engagement/ Professional Affiliation
Year:
Designation:
Organization
The nominee is of good moral standing and turpitude
The nominee has made a significant impact to the community
The nominee has made significant contribution to the life and mission of the school

Part 2 - Nominated by:

Name:
Organization:
Address: (include postcode)
Telephone:
Mobile:
Email:
Relationship to nominee:

Part 3 - References:

Please refer five individuals whom we can interview for more information on the nominee.

Name:
Address (include postcode):
Phone Number:
Email Address:

Name:
Address (include postcode):
Phone Number:
Email Address:

Name:
Address (include postcode):
Phone Number:
Email Address:

Name:
Address (include postcode):
Phone Number:
Email Address:

Name:
Address (include postcode):
Phone Number:
Email Address:

How can you help?

DONATE LCCB memorabilia to the Centennial Museum

VOLUNTEER to be part of our 100 in 100 Series

SPEAK AND SHARE during the Alumni Professional Sharing on March 7-9, 2017

DONATE and help build your school

OTHERS. In what way can you help us in our celebration?

SHARE THIS PAGE!

Contact Us

Address
Corner Galo-Gatuslao Streets
Bacolod City 6100
Negros Occidental, Philippines

Contacts
Email: lccb100years@lcc.edu.ph
Phone: +63 (034) 434 9661 to 64
Fax: +63 (034) 434 9661