WEAC Awards - Lewandowski Award Nomination Form - Wisconsin Education Association Council

Form must be submitted no later than February 1.
NOMINEE:
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
RECOMMENDED BY:
Name
First Last
Address
Street Address Address Line 2 City State ZIP Code
Home or Cell Phone
Home Email Address
SUBMITTED BY:
Name
First Last
Address
Street Address Address Line 2 City State ZIP Code
Home or Cell Phone
Home Email Address
Today's Date
MM slash DD slash YYYY
In the area below, include a detailed synopsis of past and present activities and involvement which merit the Lewandowski Award. Include specific and concrete evidence of such activities.

WEAC Lewandowski Award Nomination Form