Share Your Story

Tell us how CCC impacted your life!

Please share why CCC is important to you, how CCC impacted your life, career, and any other information that is meaningful to you.

It is our goal to share your story with other CCC alumni, staff, faculty and community members through the Community Connection.

Please take a few minutes to share your story by filling out this form.

Last Name:
Maiden Name:
First Name:
Middle Initial:
Address:
Address Line 2:
City:
State:
Zip Code:
Your Photo:	If you would like to share a photo please email Cheri Beda at cheribeda@cccneb.edu
Contact Information
Home Phone:
Mobile Phone:
Work Phone:
Email Address:
CCC Information
Years Attended CCC: (e.g. 2001-2003)
CCC Campus Location:
Graduation Year: (if applicable)
CCC Major:
Transfer Institution: (if applicable)
Employer information
Occupation:
Job Title/Position:
Employer:
CCC Experience
Explain how your life was transformed as a result of attending CCC.
Tell us about any significant, influential encounters with a professor, staff member, or other student.
How have your CCC experiences prepared you for the life you lead today?
What message would you like to share with a prospective student?
Would you be willing to have your CCC story or photo used in a CCC promotion?	Yes No
Would you be willing to be filmed by CCC's Media Technologies Department, and share your CCC story?	Yes No