GLOW Catholic School Alumni Nomination Form

St. Joseph Regional School
Distinguished Alumni of GLOW* Catholic Elementary Schools
Nomination Form

*GLOW Region refers to the Genesee, Livingston, Orleans and Wyoming Counties Region

Please complete the form below. A member of the selection committee will be in contact with you.

* Indicates required field

Name of Nominee *

First

Last

Maiden name *

Name of Nominee's GLOW Catholic Elementary School *

Year of Elementary School Graduation *

Grade at Elementary School Graduation *

Please describe why this alum should be recognized *

Name of Nominator *

First

Last

E-mail address of Nominator *

Phone Number of Nominator *

Submit

Thank you for your time!