Laubach Literacy Ontario

The Lana Faessler Outstanding Service Award

Nomination Form 2013

This award is for an employee of a Laubach Literacy Ontario agency who has given outstanding service to his/her agency and community by advancing literacy in their community. Each LLO member agency is eligible to nominate one employee each year. The employee will be currently employed with the member agency and have worked at their agency for a minimum of 5 years. The employee will have shown a dedication to their agency and to advancing the cause of literacy in their community. An Ad Hoc committee will review all nominations submitted on time and choose the winner and runner-ups.

The award winner will be announced at our Conference 2013 awards ceremony banquet atNipissing University in North Bay on Saturday, June 22, 2013.

This form must be “typed” before submitting.

Date:
Name of Agency:
Address:
Phone Number: / Fax Number:
Email address:
Name of Nominee:
Position held by Nominee in the agency
Number of years of service to the Nominating Agency:

Please answer the questions that pertain to your nominee. Feel free to use more space if necessary.

  1. What initiative(s) has the nominee generated to assist in raising awareness and/or funds for literacy in his/her community?
  1. What literacy volunteer work has the nominee participated in during his/her employment with his/her council?
  1. What upgrading has the nominee done that relates to his/her employment or his/her volunteer work?
  1. What supporting documents have been attached to this nomination?
  1. If your nominee is chosen as this year’s winner, would this person be available to accept this award at our banquetin North Bay on Saturday, June 22, 2013?

YesNo

  1. Is your nominee aware of being nominated? YesNo

Comments:

Name of Nominator:

Thank you for your time.

Please fax, email or mail to LLO by the deadline date of May 21, 2013

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