Alumni Hall of Fame Nomination Form

Deadline for Submission – April 1, 2024

All nominees must show a commitment to the Boys & Girls Club of Worcester’s mission – to help youth develop the qualities needed to become responsible citizens and community leaders, through caring professional staff who forge relationships with our youth members and influence their ability to succeed in life.

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Nominee Information

Name *

Occupation

Employer

Employer Address

Email *

Home Address *

Telephone Number *

Has your nominee continued involvement with the Boys & Girls Club or other youth service organizations? *

How has your nominee contributed to their community? *

Additional community impact, career and other information to consider:

Nominator Information

Nominator Name *

Occupation

Employer

Employer Address

Email *

Home Address *

Telephone Number *