The personal informationthat you provide on this form is being collected under the authority of the Post-Secondary Learning Act and the Freedom of Information and Protection of Privacy Act of Alberta. It will be used by the Alumni Awards Selection Committee in order to screen and select award recipients. The information will be protected in compliance with the provisions of the Freedom of Information and Protection of Privacy Act of Alberta. The information may be disclosed to the media. The information will be retained in accordance with approved Records and Information Management guidelines, after which it will be destroyed in a secure manner. If you have any questions about the collection and use of this personal information, please contact the Director of Development, Community Relations, Red Deer College, 100 College Blvd, Box 5005, Red Deer, Alberta, T4N 5H5. Telephone: 403.342.3360.

The information collected will be used by the Alumni Awards Selection Committee to screen and select award recipients as detailed below.

CANDIDATE INFORMATION

CANDIDATE’S FULL NAME
CANDIDATE’S REPRESENTATIVE / RELATIONSHIP TO CANDIDATE
Please enter the Candidate’s name as it should appear on a certificate.

CANDIDATE’S REPRESENTATIVE CONSENT

I consent to the release of this information and understand that all nominations received must meet the requirements of the “Eligibility – Screening and Selection Procedures” in the nomination package to be considered for this award. The guidelines are detailed on the Red Deer College Alumni Legacy Award Nomination form.
Nominations received will be screened and verified for compliance of nominating criteria and eligibility. The Selection Committee may interview nominators, the candidate’s representative, and other individuals as required; in order to further validate and/or expand on information contained within the nomination package.
Consent to participate in this nomination includes publication of your name through news releases and newspaper advertisements. Excerpts or statements from the nomination package may also be used at time of presentation and subsequent media coverage.
SIGNATURE / DATE

10/12