Paul Howard Award for Courage Nomination Form

A bi-annual award honoring a librarian, library board, library group, or an individual who has exhibited unusual courage of the benefit of library programs or services.

I wish to nominate the following:
Zip, Zip+4, or Canadian postal code
format 123-456-7890 x1234 (extension is optional)
Nominated by:
zip, zip+4, or Canadian postal code
format 123-456-7890 x1234 (extension is optional)