| Name of Nominee, SLA unit or organization (self-nomination accepted): | |
| _____________________________________________________________ | |
| Complete Title of Nominee: | |
| _____________________________________________________________ | |
| Employer Name: | |
| _____________________________________________________________ | |
| Preferred Address: | |
|
_____________________________________________________________ | |
| Zip/Postal Code: ______________ | |
| Country: ________________________ | |
| Phone: _________________________ | |
| Email: _________________________ | |
| Is nominee an SLA member? (Please circle) Yes No | |
| Your Name (if not nominee): _____________________________ | |
| Preferred Address: | |
|
_____________________________________________________________ | |
| Zip/Postal Code: ____________ | Country: ________________________ |
| Phone: _________________________ | |
| Email: _________________________ | |
Please include activities, which support your nomination and explain, where applicable, the results and impact of the nominee’s efforts. ISLD Award Nominations must be postmarked or received no later than May 14, 2004. Please forward all award nominations and supporting documents to:
SLA Awards & Honors Program
Special Libraries Association Headquarters
1700 18th Street NW
Washington, D.C. 20009-2514
phone: 202-939-3633
fax: 202-265-9317
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