Apalachee Audubon Society
On-line Award Nomination Form

Tab field-to-field and enter appropriate text.
Print this page, sign and date the printed form.
Mail the form via USPS to
Apalachee Audubon Society,
Awards Committee
P.O. Box 1237
Tallahassee, FL 32303
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Select the type of award requested.

Nominees Name and contact information
First Name                    Last Name

Current Position

Street Address

City State ZIP

Phone

E-mail


The nominee is not a member of  Apalachee Audubon Society.
The nominee has been an AAS member for  years.
The nominee is a deceased member of the Apalachee Audubon Society and was a member for  years.
      (If the nominee is deceased, include year of death, name and address of closest survivor, and other appropriate information along with the nomination).
The nominee is a company, group or an organization. (Please include the name and address of appropriate representative to receive the award for the nominee.)  


Attach the following information:

1. A biographical sketch of the nominee, or in the case of a group/company/organization, a brief outline of its history.

2. A statement (not to exceed 1,000 words) which describes why the nominee deserves this award (see criteria). This statement should describe activities, awards, recognitions, honors, office held, etc. Include dates when appropriate.

3.  Secondary letters of support may be included.

4. If the nominee is a group/company/organization, indicate who will accept the award in behalf of the organization and the official capacity of the individual(s).

 



This completed form should be handled as a CONFIDENTIAL document until the nominee has been selected as an award recipient. To avoid embarrassment, do not publicize your nomination before the Award Committee announcement is made.

Print, sign, and mail completed forms to the Apalachee Audubon Society, in care of The Awards Committee at P.O. Box 1237, Tallahassee, FL 32303  by February 28, 2009. 

 

Nominator's Name and Contact Information
First Name                    Last Name

Current Position

Street Address

City State ZIP

Phone

E-mail



Nominator's Signature                                               Date

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