Items with an * are required.
* First Name: First Name is required.
* Last Name: Last Name is required.
Maiden Name (if applicable):
* Address: Address is required.
* City: City is required.
* State: State is required. * Zip: Zip is required.
Email:
* Home Phone Number: Home Phone Number is required.
Cell Phone Number:
Preferred method of contact: Mail     Email     Text Cell
* Year Graduated: Year Graduated is required.
Program Graduated From:
* Degree Obtained: Degree Obtained is required.
* Current Job Title: Current Job Title is required.
* Current Employer/Business Name: Current Employer/Business Name is required.
What are your current job responsibilities?
1. Why did you pick WITCC for higher education?
2. How has WITCC helped you obtain your career goals?
3. Was WITCC helpful in helping overcome any financial obstacles, if any, in obtaining your degree?
4. Did you have any obstacles or barriers getting to or through college?
5. Would you recommend WITCC to others? If so why?
6. Did you receive a scholarship from the college?
7. If you received a scholarship, would you encourage others to give to that fund and why?
8. Other than having a successful career, would you like to mention any other honorable awards or distinctions?
9. Are you involved in any organizations that you would like mentioned?
10. What are your favorite past-times or hobbies?
11. What is the accomplishment you are most proud of at this time in your life?
12. What have been some of your hurdles in life and has having had a college education helped overcome those hurdles?
13. So many students don't go to college or continue their college education for various reasons. Do you have any personal stories that you could offer that might inspire students to go after their dreams? A story that would inspire them to say, if he/she can do it, then I can do it.
14. Do you have any words of advice to current students, job seekers, or scholarship sponsors?
15. Why do you think you have been so successful? What would you say is the secret of your success?
16. Have other people inspired you? If so, who and how?
17. Do you have any family information you would like us to include such as a spouse's name or children if you have any?
18. Other information you would like to include?
Please feel free to include a photo of yourself or a family photo if you have one .
Western Iowa Tech Community College does not discriminate on the basis of race, creed,color, gender, national origin, religion, age,
disability, sexual orientation, gender identity or other protected basis in its educational programs, activities, admission procedures, or employment practices.