nomination form - Westerville City Schools

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Westerville North High School
950 County Line Road, Westerville, OH 43081-1000
Main Office: (614) 797-6200
Fax: (614) 797-6201
Kurt Yancey, Principal
WESTERVILLE CITY SCHOOLS GRADS SOUGHT FOR
“HALL OF FAME” AWARD
The Westerville North “Hall of Fame” is open to candidates who graduated from Westerville North High
School at least ten years ago.
The Superintendent’s Student Advisory Committee at Westerville North High School and the district’s
school/community relations’ office will coordinate the program.
Nominations are particularly sought of men and women who have achieved success in their career and made
significant contributions to their field, as well as to society in general.
We welcome the nomination of any Westerville North graduate. Please be aware that as the nominator, it
will be your responsibility to ensure that your nominee is available to attend the induction ceremony and
luncheon on Friday, April 8th, 2016.
Complete the form below, and return the form to:
Principal’s Office
“Hall of Fame” Nomination
Westerville North High School
950 County Line Road
Westerville, OH 43081-1000
Name of Nominee _________________________________________________________________________
Address _________________________________________________________________________________
City _______________________________________________________State ___________ Zip ___________
Phone (Day) _________________________________ (Evening)____________________________________
Graduation Year ______________
High School_______________________________________________________________________________
Present Occupation_________________________________________________________________________
Name of Nominator __________________________________________________________________
Address ___________________________________________________________________________
City ________________________________________________________State ___________ Zip __________
Phone (Day) __________________________________ (Evening) __________________________________
Nomination deadline: January 29, 2016
John R. Kellogg, Ed. D., Superintendent/CEO
Visit us at www.westerville.k12.oh.us
Vision: Our vision is to be the benchmark of educational excellence.
Mission: Our mission is to prepare students to contribute to the competitive and changing world in which we live.
Values: Respect, Inclusiveness, Community, Communication, Collaboration, Innovation, Nurturing, Trust, Accountability
Westerville North High School
950 County Line Road, Westerville, OH 43081-1000
Main Office: (614) 797-6200
Fax: (614) 797-6201
Kurt Yancey, Principal
Westerville City Schools Alumni
INFORMATION SHEET
Please type or print responses below and mail to:
Westerville North High School
950 County Line Road
Westerville, OH 43081-1000
Name_____________________________________________________________________________
Current Address____________________________________________________________________
City, State, Zip _____________________________________Phone___________________________
Westerville High School Activities and Honors:
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
College/University/Post-Graduate Training Completed:
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
College/University/Training Institution Attended:
_________________________________________________________________________________
_________________________________________________________________________________
Present Career/Occupation:
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
Community Involvement:
_________________________________________________________________________________
_________________________________________________________________________________
Comments:
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
Nomination deadline: January 29, 2016
John R. Kellogg, Ed. D., Superintendent/CEO
Visit us at www.westerville.k12.oh.us
Vision: Our vision is to be the benchmark of educational excellence.
Mission: Our mission is to prepare students to contribute to the competitive and changing world in which we live.
Values: Respect, Inclusiveness, Community, Communication, Collaboration, Innovation, Nurturing, Trust, Accountability
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