Nomination Form

Each year, FILLS presents this award to a local library in honor of outstanding service to underserved groups and people with special needs. Library outreach can be any program, resource, partnership, service, or activity that helps targeted outreach populations use library resources.

* 1. Your Nomination:

* 2. Which targeted group is served by your nomination? (check any/all that apply)

* 3. Please tell us a bit about your nomination. What kind of outreach has your nominee provided, and how has it helped members of the above group(s) to use their library?

* 4. How often does this outreach activity occur, and how did it develop? Was it new this year, or ongoing?

* 5. Have any other local organizations or groups been involved?

* 6. In what ways has this outreach activity been successful?

* 7. Are there plans to continue this outreach activity in the future?

* 8. Your Contact Information (optional, but helpful in case we have questions):