APPLICATION FOR NYSRA COUNCIL SERVICE AWARD

Council: ___________________________________________________________

President's Name: __________________________________________________

EXPLANATION:

Each local council of NYSRA in good standing is eligible to nominate a recipient for this award. The criteria must be met by April 1, 2004 and postmarked to NYSRA by that date.

CRITERIA:

The recipient of this award:

1. Must have been a member in good standing of the nominating council for at least five consecutive years (unless the council has been in existence for a lesser period).
2. Must have been continually active in local council activities.
3. Must have made significant contributions to local council programs.
4. Must be a staunch supporter of the goals of the New York State Reading Association.

NAME OF AWARD RECIPIENT:

MAILING ADDRESS:

RETURN TO:

Lawrence Kline
223 Homewood Drive
Clinton, NY 13323

DEADLINE: April 1, 2004