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
ography ofthis nominee. Use these questions
to help with the writing of the biography.
Please attach a brie
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?
1s the nomince being paid for the services referenced inthe nomination? []yes C]n0
‘You may attach press clippings, brochures, or any other materials that show the efforts of this nominee (not required.)
to any ESL branch or to:
Return your nomination form by February 11, 2019
ESL Jefferson Awards
225 Chestnut Street
Rochester, New York 14604
What makes our American democracy work is individual
barticipation and dedication to better serve our nation.
The ESL Jefferson Awards are about Rochester area
citizens making a difference,
NEWS
14
WHEC-TY ROCHESTER, WY
Questions? Please call ESL at 585-336-1095 or log on to www.esLorg for more information.
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