Catherina Cittadini School

Calindagan, Dumaguete City

Search for Outstanding Alumni Award 2015

Nomination Form

(Please print necessary information. Additional sheets may be added to accommodate more information)

I. PERSONAL INFORMATION

Nominees Full Name: ____________________________________________________________

(Surname) (Given Name) (Middle Name)

Home Address:_______________________________________________________________________
(No. & Street) (Barangay)

Contact No. _______________________________ E-mail Add ____________________________

Place of Birth ______________________________________________ Age _________

Civil Status ______________________ Name of Spouse if married ______________________________

Family Background:

Father:____________________________________ Mother: _______________________________

Address: _______________________________________________________________________________

No. of children in the Family ________ Means of livelihood of parents _____________________

II. EDUCATIONAL ATTAINMENT

Background:

Level School Attended Course or Degree Year Completed

Elementary ___________________________ ________________________ _____________

Secondary ___________________________ ________________________ _____________

College ___________________________ ________________________ _____________
Graduate Studies ___________________________ ________________________ _____________
Post Graduate Studies ________________________ ________________________ _____________
Awards/ Scholarship Granted:

Nature of Award or Scholarship Purpose Year Granted

________________________________ ________________________ ___________________________

________________________________ ________________________ ___________________________

III. EMPLOYMENT

Occupation/ Profession: ____________________________________

Latest Position/ Title: ______________________________________
Agency/ Employer: ________________________________________
Company Address: _______________________________________

IV. AFFILIATIONS (Civic, NGO, Professional, Religious, or Business Organizations)

Name of Organization Position Period / Date (from-to)

_____________________________ __________________________ ___________________________

_____________________________ __________________________ ___________________________

_____________________________ __________________________ ___________________________

_____________________________ __________________________ ____________________________

V. AWARDS AND RECOGNITIONS RECEIVED

Recognition or Award Sponsor or Given by Date Awarded

_____________________________ __________________________ ___________________________

_____________________________ __________________________ ___________________________

VI. SERVICES, COMMITMENT, LEADERSHIP, AND PIONEERING ZEAL

Work Experience:

Employer/Agency Position Held Period (from-to)

_____________________________ __________________________ ___________________________

_____________________________ __________________________ ___________________________

VII. ADVOCACY PROJECTS and / or PROGRAMS INITIATED THAT BENIFITED THE PEOPLE
IN HIS/HER COMMUNITY

Title of Project/Programs Initiated Place Date of Implementation

________________________________________ ____________________ __________________________

________________________________________ ____________________ ________________________

VIII. NOMINEES ACHIEVEMENTS / ACCOMPLISHMENT IN SUMMARY

(in line with his/ her field of endeavor/ interest in terms of the following)

Personality ______________________________________________________

Achievements ______________________________________________________

Innovative Work ______________________________________________________

Outstanding Contribution ______________________________________________________

In narrative form, cite nominees achievements that have impact on the general welfare of the people as
SPEAKER, TEACHER, LECTURER,WRITER, PERFORMER, FARMER, PREACHER,
ECONOMER, LEADER, ETC

__________________________________________________________________________________________

__________________________________________________________________________________________

IX. REFERENCE OF AT LEAST FIVE (5) PERSONS OF GOOD STANDING

Name/ Position in the Municipality/ Contact No./ Address/

1.

2.

3.

4.

5.

The undersigned certifies that the above information of the nominee are true to the best of his/her
knowledge.

_______________________________

Nominator

This nomination form is further certified true and correct by the nominee himself/herself. Attached are
the nominees supporting documents.

_________________________________

Nominee
 Catherina Cittadini (St. Louis) School
Guidelines for the Search for the Most Outstanding Alumni Award

I. Purpose
The purpose of the Most Outstanding Alumni is to provide recognition for outstanding achievements
by the alumni of CCSLS. This award is given to alumni who have reached peak of their careers and
have brought credit to themselves and to the Cittadine Family.

II. Objectives
1. To keep the values inculcated by Mother Catherina Cittadini.
2. To promote and keep alive the love, spirit, and gratitude to our alma mater.
3. To engage in academic and social activities that shall contribute towards promoting healthy
relationship between the Alumni and Catherina Cittadini (St. Louis) School.
4. To attract new students and developing more graduates of the same outstanding quality that
Cittadini School has to offer.

III. Eligibility of the Award

1. Bonafide Cittadini Alumni for 10 years (Batch 2003, 2004, 2005, 2006 , 2007 ) are eligible for this
award.
2. The nominee shall have been outstanding in his/her chosen field of endeavor.
3. The nominee shall have been made significant contributions benefiting his/her school, workplace
and the community as a whole.

IV. Nominations
1. Only Alumni, Faculty and staff of CCSLS can nominate. The Alumnus/Alumna cannot nominate
himself/herself.
2. Nominators must complete the Alumni Nomination Form. Pertinent documents must be attached
to the form.
3. Deadline of submission of Nominees for Outstanding Alumni will be on November 18, 2017.

V. Selection Process
1. The Selection/Screening Committee will be called the Alumni Awards Committee and shall be
composed of the Ursuline Sisters, Administration, chosen Faculty and Staff of CCSLS. It will be
the Ursuline Sisters who will choose the Faculty and Staff to be part of the Screening Committee.
2. Among the nominees submitted, only five (5) will be selected by the Screening Committee and
they will be introduced during the Alumni Homecoming.
3. The Alumni Batch Officers sponsoring the Alumni Homecoming must inform to the batch
representatives of each batch who are the candidates that will be selected during the Final
Screening of the Award.
4. It will be the duty of the Alumni Awards Committee to make the final selection process (done on
the 1st week of December 2017).. The review process is confidential.
5. The decision of the Alumni Awards Committee is final and irrevocable.

VI. Recipients
1. There will only be one (1) Most Outstanding Alumnus/Alumna.
2. The award will be presented during the Grand Alumni Homecoming on December 16, 2017.
3. The recipient of the award must appear during the Grand Alumni Homecoming to receive the
award. If the awardee is unable to come due to unavoidable circumstances, immediate family or
any batch representative from his/her batch may proxy him/her.
4. The Most Outstanding Alumnus/Alumna will be given a Plaque sponsored by the Alumni Batch
sponsoring the Grand Alumni Homecoming.