COMMACK HIGH SCHOOL ALUMNI OF DISTINCTION
NOMINATION FORM
TO:
Members of the Commack Community
FROM:
Commack Alumni of Distinction Committee
As you probably know, each year the Commack School District honors Commack alumni based on career achievements,
community involvement, charitable work, etc. Our committee will be meeting to choose our honorees soon. Please have
the application completely filled out and returned to:
Commack Alumni of Distinction
Commack High School
Scholar Lane
Commack, NY 11725
1.
Alumni of Distinction Nomination
Selections will be based on:
 Graduation date from Commack; ten (10) years prior to June 2012.
 Outstanding contributions to the welfare of mankind and service to the community.
 Significant accomplishments in field of work. You may nominate yourself or another alumna/alumnus.
2.
Nomination form must be received by September 1, 2012.
3.
Please include a detailed biography citing the nominee's accomplishments, service, field of work, etc. with
each application.
Nominee's Name:________________________________________Graduating Class of_______________________
School (circle):
Commack North
Commack South
Commack High School
Address:__________________________________________________________________________________________
E-Mail:___________________________________________________________________________________________
Telephone #: Home______________________________Work or Cell _______________________________________
Person providing nomination:________________________________________________________________________
Address:__________________________________________________________________________________________
E-Mail:___________________________________________________________________________________________
Telephone #: Home________________________________Work or Cell _____________________________________