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DGO Nomination Form
Who is your Nominee?
First Name
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required
Last Name
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required
PWHS Graduation Year
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required
What category best applies?*
Academics
Arts
Athletics
Business
Humanities
Public Service
Why should this person be named a PWHS Distringuished Graduate?
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Please include the nominee's greatest accomplishments.
Career
Position
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required
Organization
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City/State
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Year From-To
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required
Do you have another position to list?
Yes
Position
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required
Organization
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required
City/State
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required
Year From-To
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required
Do you have another position to list?
Yes
Position
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required
Organization
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required
City/State
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required
Year From-To
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required
Education
Has the Nominee earned a college degree?*
Yes
No
Degree
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required
School
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required
City/State
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required
Year(s) of Degree or Attendance
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required
Do you have another Earned Degree to list?
Yes
Earned Degree
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required
School
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required
City/State
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required
Year(s) of Degree or Attendance
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required
Do you have another Earned Degree to list?
Yes
Earned Degree
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required
School
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required
City/State
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required
Year(s) of Degree or Attendance
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Does the Nominee have any Professional Certifications?*
Yes
No
Please list any professional certifications this person has.
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required
Please include the certification name and certifying body.
Military Service
Has your Nominee ever served in the military?*
Yes
No
Branch of Service
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required
Year From-To
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Location
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Highest Rank
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Professional Memberships
Has your Nominee been a part of any professional organizations/committees/etc.?*
Yes
No
Please list the organizations/committees and any relevant positions held.
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Media
Has your Nominee been featured in the media?*
Yes
No
Title of media
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required
Name of Podcast, Magazine, etc.
Title of story or feature
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What medium?*
Book
Magazine
Newspaper
Podcast
Radio
Television
Web
Link (if available)
Do you have another feature to list?
Yes
Title of media
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required
Name of Podcast, Magazine, etc.
Title of story or feature
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required
What medium?*
Book
Magazine
Newspaper
Podcast
Radio
Television
Web
Link (if available)
Community Involvement
Is your Nominee involved in the community?*
Yes
No
Plese list organizations and relevant positions.
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required
Awards/Honors/Grants
Has your Nominee won any Awards, Honors or Grants?*
Yes
No
Please list any Awards, Honors, or Grants.
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Avocations
Hobbies/Recreational Activities
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Nominee Contact Information
Email
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Phone
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Address
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Is your Nominee married?*
Yes
No
Spouse's Name
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required
Does your Nominee have any children?*
Yes
No
Children's Names
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required
Submitted By
Name
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required
Email
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required
Phone
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required