FLICC Library/Information Center of the Year Award
Nomination Form

Identify exemplars which demonstrate nominees' qualification for this award (http://www.loc.gov/flicc/Awards/previous_year_exemplars.html) and use them as a guide in completing the application packet.

This is not an interactive Web form.

Fill out the form, print it via your browser and get required endorsements and signatures.  Then fax or mail according to the instructions below.

NOMINEE (PLEASE PRINT:)
Library/Information Center Name:
Name of Director/Head:
Agency:
Library Address:
City:
State:     Zip:  
Phone:
Fax:
Email:
Number and type of Users/Patrons:*

Number of Staff
(In-house and Contracted):*
Total Annual Budget from All Sources (including salaries, acquisitions, and other operating expenditures) :*


Additional comments or explanations:
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________

NOMINATOR:
Name:
Title:
Organization:
Preferred Address:
City:
State:      Zip:  
Phone:
Fax:
Email:
Relaltionship to Nominee:
Nomination statement (mandatory): I believe the nominee should be Federal Library or Information Center of the Year for Fiscal Year 2011 because (50 words or less)
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
Signature:      Date:    

MANAGEMENT APPROVAL (Organization above the Library/Information Center):
Name:
Title:
Organization:
Statement of approval: I approve this nomination for Library/Information Center of the Fiscal Year. Comment:
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Signature:
Date:

INSTRUCTIONS:
Deadlines: All nominations must be faxed no later than Friday, January 13, 2012. If a nominator does not receive confirmation of the nomination by Friday, January 20, 2012, please contact Lizzie Daniels by phone at (202) 707-4813. Fax nominations to the Federal Library and Information Center Committee (FLICC) at (202) 707-4825. The FLICC Awards Working Group will receive and screen applications and submit a list of finalists to the FLICC Executive Board. The FLICC Executive Board will make the final selection and announce the winners at the FEDLINK Membership Meeting in the spring of 2012.