Outstanding Learner Award Nomination Form

Criteria for Awards

Nominees must be learners who are currently active or who have been active within the past year.
Strong candidates are learners who have:
- Made an impact on the adult literacy effort in a community or across Minnesota.
- Contributed unique, innovative or creative perspectives to their programs.
- Shown a commitment to the adult literacy community.
- Demonstrated leadership abilities.
Nominees may have volunteered with a literacy program, however, this is not a requirement.
Former winners of the Outstanding Learner award are ineligible.
Nominations are due by 5:00 p.m. on Friday, March 22, 2013.

Learner's Information

First Name *

Last Name *

Street Address *

City *

State

ZIP Code *

Phone *

Your Information

First Name *

Last Name *

Street Address *

City *

State

ZIP Code *

Phone *

Email *

Title *

Program Name *

Program Location *

Please answer ALL of the following questions. Please note that the best nominations are those that include supporting evidence, example, and stories. Please be as thorough and specific as possible within the word count limits.

How long has this learner been active in your organization (50 words or less)? *

How did he/she first become involved in your literacy program (100 words or less)? *

What leadership role(s) does this individual currently play in your program, if any, and how did s/he emerge as a leader (200 words or less)? *

In what way is this learner’s involvement in your program unique, innovative or creative (250 words or less)? *

What personal characteristics and experiences make him/her a successful learner (200 words or less)? *

What has this learner contributed to your program and how have their contributions benefited your program (200 words or less)? *

What barriers or challenges has this learner overcome to get where they are today and/or what other ways is this learner involved in his/her community (200 words or less)? *

Additional comments:

If you have additional documentation for this nomination, please email, fax or mail them to:

Cathy Grady
Minnesota Literacy Council
700 Raymond Avenue, Suite 180
St. Paul, MN 55114
cgrady@mnliteracy.org
fax: 651-645-2272

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