Information provided will be shared only for purposes related to The ESL Jefferson Awards. Full Name of Nominee _____ | Full Name of Nominator. Street Address, Street Address, City State___Zip. City. State___Zip. Daytime Phone Daytime Phone Evening Phone Evening Phone. Biography of the Nominee Please attach a brief biography ofthis nominee, Use these questions to help with the writing of the biography. 1. How has this nominee favorably impacted the community? 2. How many years has this nominee given to service in the community? 3. What makes this individual deserving of an ESL Jefferson Award? Is the nominee being paid forthe services referenced inthe nomination? []yes []no ‘You may attach press clippings, brochures, or any other materials that show the efforts ofthis nominee (not required.) ;Retur your nomination form by February 12,2018 to any ESL branch or to: I SI ESL Jefferson Awards 225 Chestnut Street Rochester, New York 14604 Federal Credit Union What makes our American democracy work is individual participation and dedication to better serve our nation. ‘The ESL Jefferson Awards are about Rochester area citizens making a difference. NEWS \WAEL-TV RCRESTER, mY Questions? Please call ESL at 585-336-1095 oF log on to www.slorg for more information play of Hers INC Empat, ard Mens, ed ine foil mens ing re Kw eh ES mee) [SSL Feea! Cet Uno, ES loves Sti Lo ES Tat Servis att eg