LEA FRIEND OF EDUCATION AWARD
Application Nomination Form
Type or Print:
Nominator: (Print) ____________________________________________________________
Nominator: (Signature)_________________________________________________________
Association Position:___________________________________________________________
Lakota Work Site:_____________________________________________________________
| Work Phone:___________________ | Home Phone:_________________ |
Brief Description of Nominee
I hereby nominate the following individual/organization to receive the LEA Friend
of Education Award.
NOMINEE:_________________________________________________________________
Individual or Organization ______________________________________________________
Address _____________________________________________________________________
| City_____________________________________________ | State______ | Zip_________ |
| Work Phone:___________________ | Home Phone:_________________ |
Please describe in the space provided the reasons for nomination and qualifications of the nominee in 100 words or less. Please give specific examples of the contributions and activities pertaining to the individual or organization. You may attach supporting documents to substantiate your nomination.
This Award is funded with OEA Effective Local Grant Money
Last update: 1/12/07