FOR YOUR RECORDS, PLEASE PRINT ONE COPY OF THIS COMPLETED FORM BEFORE PRESSING THE "DONE" BUTTON. Please include a copy of the form with any documents you'll be including to support this submission. SEND THE DOCUMENTS by scanning them and attaching them as pdfs in an email to Lawrence Baines at lbaines@ou.edu OR mail them postmarked no later than May 1 to Lawrence Baines, 2720 Fairfield Drive, Norman, OK 73072-9636.

NOTE: You may copy long responses from WORD or another word-processing program and paste them into the survey form.

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* 1. Please provide the following information about your affiliate.

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* 2. Please provide a 1-2 page summary (250-500 words) describing your affiliate's multicultural programming.

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* 3. Please provide a brief description of your affiliate's multicultural program entry (50 words or fewer) to be printed in the Affiliate Breakfast Program if your affiliate wins the award.

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* 4. Please list any documents you'll be including to support your submission. THEN SEND THE DOCUMENTS by scanning them and attaching them as pdfs in an email.

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* 5. If recognized, would your affiliate be responsible for having a representative on hand for the awards presentation at the Affiliate Breakfast during the NCTE Annual Convention? (NOTE: The representative is expected to purchase a breakfast ticket with preregistration.)

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* 6. If you answered, "yes," please provide the name and contact information for the representative.

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* 7. We'd like to contact the media in your area. Please let us know which newspaper(s) should receive a press release.

FOR YOUR RECORDS, PLEASE PRINT ONE COPY OF THIS COMPLETED FORM BEFORE PRESSING THE "DONE" BUTTON. Please include a copy of the form with any documents you'll be including to support this submission. SEND THE DOCUMENTS by scanning them and attaching them as pdfs in an email to Lawrence Baines at lbaines@ou.edu OR mail them postmarked no later than May 1 to Lawrence Baines, 2720 Fairfield Drive, Norman, OK 73072-9636.

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