This application form is to be used to apply for the Louis E. Yavner Citizen Award. For more information regarding the Louis E. Yavner Citizen Award, please visit the Office of Standards and Instruction's Louis E. Yavner Teaching and Citizen Awards page.
APPLICATION GUIDELINES

ALL APPLICATIONS MUST BE SUBMITTED ON OR BEFORE FRIDAY, NOVEMBER 21, 2025, 5:00 PM

IMPORTANT REMINDERS:

Make sure any scanned pages are completely legible.
If any material is missing from the submission, other than if it is not applicable, the application will be considered incomplete and will not be reviewed.
Materials received after 5:00 pm on November 21, 2025, will be automatically declined for submission for the award.
SECTION I: CANDIDATE INFORMATION

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* 1. Candidate's Name

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* 2. Title or Position

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* 3. Home Address

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* 5. Telephone or Cell Number

SECTION II: NOMINATOR INFORMATION

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* 6. Name of Nominator

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* 7. Title or Position of Nominator

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* 8. Business Address

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* 10. Telephone Number

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* 11. Letter of recommendation

SECTION III: REFERENCES/SUPPORTERS OF NOMINATION
First Reference/Supporter

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* 12. Name

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* 13. Title or Position

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* 15. Telephone or Cell Number

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* 16. Letter of Recommendation

Second Reference or Supporter

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* 17. Name

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* 18. Title or Position

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* 20. Telephone Number

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* 21. Upload letter of recommendation

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* 22. Short biography

SECTION IV: BIOGRAPHY

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* 23. Short Biography

SECTION V: RESUME

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* 24. Resume upload

SECTION VI: IMPACT OF CANDIDATE

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* 25. Upload letters that have been received from others regarding the impact of the candidate.

SECTION VII: MATERIALS DEVELOPED OR PUBLISHED

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* 26. If applicable, upload any materials that have been developed or published. Reference to this work should be included in the documentation.

Before final submission, please double check and ensure the following have been included:

- A letter of recommendation from the nominator summarizing the nominee’s contributions;
- Two additional letters of recommendation;
- A short biography;
- A resume, including a chronological listing of activities (e.g., classes, workshops, presentations, exhibits), awards and/or honors received, and publications;
- Letters received from others regarding the impact of the candidate
- Example of materials developed and/or published, if any; and
- Media reports of activities, if any.

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