N ational Council of La Raza 2005 A wards N omination Form I hereby nominate: **
Name Title Company Address City Phone
State Fax
Suite/Apt. Zip Email
Please check if this nomination is a resubmission; if so, please provide an updated description of programs. ** The recipients selected to receive an award must be present at the Awards Show ceremony to accept their honor on Tuesday, July 19, 2005 at the NCLR Annual Conference in Philadelphia, PA. It is your responsibility to inform the person of his/her impending nomination.
I hereby nominate the above person for the following award (check one): Graciela Olivarez La Raza Award for philanthropy / leadership on a national level Maclovio Barraza Award for Leadership, primarily on local / regional level Ruben Salazar Award for Communications Roberto Clemente Award for Sports Excellence Submitted by:
Name Title Company Address City Phone
State Fax
Suite/Apt. Zip Email
Submission Format Page 1
A Completed Awards Nomination Form (this page)
Page 2
Summarize the nominee s biography and why he or she should receive the award. (If your nominee is selected, portions of this summary will be used for the article in the program book.)
Pages 3 5
Please type out the following questions followed by the answer: 1. Describe nominee s educational and professional experience, and ethnic background. 2. Describe nominee s programs and/or work, including participation in and service to the community. 3. How significant and influential is the nominee s work on the national scope, or is it likely to become so? Broad applicability is also important. 4. How outstanding and inspirational has the nominee s contribution been to Hispanics? 5. List other recognition received by nominee, including awards, honors, medals, etc. (If your nominee is selected, portions of these answers may be used for the article in the program book.)
Email or fax this nomination to: Miguel Munguia, Events & Logistics Coordinator, National Council of La Raza (202) 785-5384, ext. 101 ~ (202) 318-0753 fax ~ mmunguia@nclr.org Nominations should be no more than five pages, including this form and letters of recommendation or articles. Anything over five pages will be eliminated. Unanswered questions and an incomplete form may cause your nomination to be eliminated. Individuals or groups both inside and outside the NCLR affiliate network may nominate a person; however, persons may not nominate themselves.
DEADLINE FOR SUBMISSIONS: SEPTEMBER 1, 2004