CHILIS

CHILIS Librarian of the Year Award Nomination Form

I nominate the following individual for the CHILIS Librarian of the Year Award:

Name _______________________________________________________

Library where employed _______________________________________

Position held__________________________________________________

Library Address:______________________________________________

_______________________________________________

Phone number _____________________________________

E-mail_______________________________________

I can be contacted at:

Name of Nominator____________________________________________

Library where employed _______________________________________

Position held__________________________________________________

Library Address:______________________________________________

_______________________________________________

Phone Number _____________________________________

E-mail_______________________________________

Please tell why you are nominating this person for the award and explain how the individual fits the award criteria. You may want to attach your answer to this form.

Please include the name and contact information for an additional reference who can second the nomination.

Name of additional reference______________________________

Library______________________________

Phone_____________________

E-mail______________________________

Signature of Nominator ________________________________________

Date__________________________________________

How to Submit

Please send this form (postmarked no later than January 15th) to:

CHILIS/NHLA

c/o Local Government Center

PO Box 617

Concord, NH 03302-0617