ISLD Award Nomination Form
ISLD Award Nomination Form

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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