Nomination Form for
2011 Kansas Authors Club Awards of Merit
Awards for achievement in writing, service to Kansas Authors Club, or a special accomplishment are presented to deserving Kansas Authors Club members at the Annual Conference. Nominations should be sent no later than July 1, 2011, to be considered. Forms may be sent either by e-mail or by regular posted mail. Award winners will be selected by ballot by a committee of Kansas Authors Club members, previous award recipients, and non-members, chosen by the Awards Chair.
Please give careful consideration to your reasons why the nominee is worthy of an award and list them below. If this person is to be considered for the achievement in writing award, then please list publications of the person’s writing, either published and/or self-published. For the service award, list what services were done both on the district and state level, how long the person held an office, etc. For the special accomplishment award, list when, where, and what this was, and describe the accomplishment. You may add more details on attached pages. Contact Annette Wood, Awards Chair, send e-mail to Alan, if you have questions. Nominations may be made by any individual member of Kansas Authors Club, by a group, or by a district.
I nominate (full name) _________________________________________, District
#________, for a (circle one) Service, Achievement or Special Accomplishment Award.
The reasons I feel this person is worthy of this award are
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
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____________________________________________________________________
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Nominated by (please print): _____________________________________________
Nominator’s signature:__________________________________________________
Date ________________________________________________________________
Send completed form with all attachments to:
Dr. Alan D'Souza
644 N. Poplar St.
Wichita, KS 67214
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