Sullivan Award Nomination Form

An annual award presented to an individual who has shown exceptional understanding and support of public library service to children while having general management/supervisory/administrative responsibility that has included public library service to children in its scope.

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I wish to nominate the following:

Nominee Name *

Nominee's Job Title *

Library or Organization *

Nominee Street address *

Nominee's City *

Nominee's State/Province *

Nominee's Zip or Postal Code *

Zip, Zip+4, or Canadian postal code

Nominee's Phone Number *

Format 123-456-7890 x1234 (extension is optional)

Nominee's Fax Number

Nominee's Email *

Nominated by:

Nominator's Name *

Nominator's Street address *

Nominator's City *

Nominator's State/Province *

Nominator's Zip or Postal Code *

Zip, Zip+4, or Canadian postal code

Nominator's Phone Number *

Format 123-456-7890 x1234 (extension is optional)

Nominator's Fax Number

Nominator's Email *

Please upload a statement explaining this nominee's contributions, which should include the following:

Brief career summary - title, library, dates (chronological order
Educational background
Membership/participation in professional organizations - functions, dates
Pulbications, productions, and presentations
Other significant contributions

Due to a bug, DO NOT press the upload button after the file name. Simply select the file(s), and then submit the form.

Statement of contributions *

Only files with the following extensions are allowed: pdf
More information

Files must be less than 2 MB.
Allowed file types: pdf.

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