2018 NCTE Affiliate Intellectual Freedom Award Application Established in 1997, this award is given by affiliates to individuals, groups, or institutions that merit recognition for advancing the cause of intellectual freedom. Deadline for application is May 1. Question Title * 1. Complete name of affiliate giving the award: Question Title * 2. Please give contact information for the nominator (contact person) for the award. Name of Nominator and Contact Person for the Award: Position in Affiliate: Street Address: City: State/Province: Zip Code: Email Address: Phone Number: Question Title * 3. Please give contact information of award recipient. Name: Institutional Affiliation: Preferred Address (indicate H or O): City: State/Province: Zip Code: Email Address: Phone Number (indicate O, H, or C): Question Title * 4. Does the recipient give her/his permission to receive this award? Yes No Other (please specify) Question Title * 5. Explain in fewer than 100 words why the nominee merits this recognition (this explanation will be used in descriptions of award winner for the Affiliate Breakfast program and press release): Question Title * 6. Paste in concise documentation and/or testimony of not less than 250 words or more than 750 words explaining why the nominee merits this award. Question Title * 7. Please provide the name and city of the newspaper to be contacted about the award winner. Question Title * 8. Will the award winner be able to attend the NCTE Annual Convention to be recognized at the Sunday morning Affiliate Breakfast? Should your awardee be unable to attend the Convention, please contact NCTE so we can plan to recognize the winner at the Breakfast and send the certificate by mail. Yes No Other (please specify) 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 may be mailing in support of this submission. SEND THE DOCUMENTS by May 1 to NCTE Affiliate Office, 1111 W. Kenyon Road, Urbana, IL 61801; affsec@ncte.org or Linda Walters-Moore, lwaltersmoore@ncte.org. Done