Nomination and photograph of the nominee must be received together by 5 p.m. September 28, 2007. Electronic submission is required. E-mail the completed nomination to Stan Dixon, Chairman of Awards and Recognition Committee, at stan_dixon@ncsu.edu. (Exception: Nominations and print photographs submitted by retirees may be sent by mail but must reach chair by stated deadline. Mail to:Stan Dixon, Greene County Cooperative Extension Center, 229 Kingold Blvd Snow Hill, NC 28580.)

Nominations more than 1 (one) page (back and front) will NOT be reviewed. Award nominations will only be accepted in straight text, Microsoft Word or StarOffice writer format. No HTML or PDF formats will be accepted. Margins must be 1-inch and information presented must be of 10-point type.

DESCRIPTION: This award recognizes a retired ESP member for continuing contributions and outstanding service.

INFORMATION ABOUT THE NOMINEE

Full Name
Title
Current Address
Phone
E-mail Address
Educational Background (Include schools, colleges, universities, dates attended, degrees.)
Career (State positions held, listing the most recently held position first.)

Statement of Significant Contribution/Service Since Retirement:

Summary Statement of Support (concise, well-written, easy-to-read statement of 50-75 words)

INFORMATION ABOUT THE NOMINATOR
Name
County

Date

Xi Chapter ESP