WEAC Awards - Cunningham Dickinson Watson Staff Award Nomination Form

Form must be submitted no later than January 25.

I WOULD LIKE TO NOMINATE:

Name

First Last

Nominee's job title and place of employment

Address

Street Address Address Line 2 City State ZIP Code

Home or Cell Phone

Home Email Address

SUBMITTER INFORMATION:

Your Name

First Last

Your Address

Street Address Address Line 2 City State ZIP Code

Your Home or Cell Phone

Your Home Email Address

Today's Date

In the area below, please indicate why the nominee deserves consideration for the Cunningham, Dickinson, Watson Award. Letters of recommendation also will be considered. These can be sent separately as email attachments to Jason Mathews at mathewsj@weac.org or by mail to Jason Mathews, WEAC, PO Box 8003, Madison, WI 53708. Please be sure to indicate the name of the nominee on these submissions.

WEAC Cunningham, Dickinson, Watson Staff Award Nomination Form