WLLA AWARDS NOMINATION FORM

Award Title (please circle)

Distinguished Service
Outstanding Adult Educator
Outstanding ABE/GED/ESL Educator

 Deadline - September 15, 2009

Award of Commendation
Outstanding Community Service Educator
Outstanding Regional Leader

 

Name________________________________________________________________________

 
Address______________________________________________________________________

 
Region Represented (if appropriate)_______________________________________________

 
Rationale for Nomination: (must be completed, feel free to attach supporting meterials)

 

 

 

 

 

 

___________________________________________________
Name of Person Submitting Nomination		  _____________________________________
Region

Mail or Fax all materials to:
 John Tollakson
Box 1500, Sheridan College
Sheridan, WY 82801
E-mail: johnt@sheridan.edu