Nomination Form

 

Please fill out the electronic portion of the Crystal Apple Awards nomination form and mail additional support materials using the contact information provided below. It is the responsibility of the nominator to see that the nomination packet is submitted completely and accurately. Please review nomination instructions and tips for Individual and Business before submitting this form. Nominations must be received by 5 p.m., October 8, 2010.

Mail additional support materials to:
Mary Paulson
Salem-Keizer Public Schools
2450 Lancaster Dr. NE, Suite 202
Salem, OR 97305

Questions? Call Mary Paulson at 503 399-3001

Award Category
Nominee Name
Job Title
School or Dept.
Address
City
Zip
Phone
Supervisor
Website
Type of Business
Check boxes that apply:
Worked for SKSD or private school more than 3 years.
Has not been nominated for a Crystal Apple in the last 2 years.
Submitted By
Address
City
State
Zip
Phone
E-Mail
Relationship
Copy and paste the 3 required letters of reference you into the following fields. If you would prefer to send in hard copies, please mail them in at the address above.
Letter of reference 1
Letter of reference 2
Letter of reference 3