Barbers Hill Independent School District
Distinguished Alumnus/Honorary Eagle
2013 Nomination Form
Nominations are due to the BHISD Central Administration Office by Tuesday, April 30, 2013
The Distinguished Alumni Selection Committee seeks alumni who have demonstrated the
character traits of leadership and service, with the nominee’s personal and professional
successes being an additional factor. Examples include:
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Active participation in community, state, or national activities
Evidence of lasting contribution to an organization, business, or society in general
Exhibited leadership ability
Distinction in personal and professional life
Barbers Hill Class of 1929 - 1990
Honorary Eagles are individuals who are not Barbers Hill graduates but who have had a lasting
and profound effect on Barbers Hill, its students, and its community through involvement,
leadership and support. Because leadership skills can take years to develop, we request that
nominees be over the age of 40.
One Distinguished Alumnus and one Honorary Eagle will be selected annually from the
nominations received. For more information, contact Carla Rabalais, Barbers Hill ISD Public
Information Officer, CRabalais@bhisd.net , or call 281.576.2221 x 1220.
Your Name (Nominator): ________________________________________________
Name of Nominee: _____________________________________________________
Nominee is a Barbers Hill graduate
or
Honorary Eagle
Barbers Hill Class of: ____________________________________________________
Nominee Mailing address: _______________________________________________
_______________________________________________
Nominee Phone Number: _______________________________________________
Nominee Email Address: _________________________________________________
Nominee’s Business Title (if applicable): _____________________________________
Nominee’s area of Business or Profession: __________________________________
Degree(s): Bachelor: _________ Master: ___________ Doctorate: _____________
Major: __________________ College: _______________________________
Major: __________________ College: _______________________________
Other certifications: ________________________________________________
Why should this nominee be selected to receive this Distinguished Alumnus award?
(Attach separate sheet if needed)
How do you know this individual?
Does the nominee know that you have nominated him/her?
Nominee’s educational experiences and awards:
Nominee’s business/professional awards, honors, and achievements:
Nominee’s community service, honors, and awards (including civic, religious, youth, and
philanthropic activities):
Information about nominee’s family (spouse, names and ages of children, Barbers Hill
students? etc.)
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Nominator information:
Nominator Name: ______________________________________________________
Nominator Address: ____________________________________________________
_____________________________________________________________________
Nominator Home/Cell Telephone: _________________________________________
Nominator Email address: _______________________________________________
Nominator’s signature (required): ____________________________________
Please return this completed form to:
Distinguished Alumni Selection Committee
Attention: Carla Rabalais
Barbers Hill ISD
P.O. Box 1108
Mont Belvieu, Texas 77580
Nominations are due to the BHISD Central Administration Office by
Tuesday, April 30, 2013
Thank you for your nomination!
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