FLICC Library Technician of the Year Award Nomination Form

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:)
Name:
Title:
Agency:
Library Address:
City:
State:	Zip:
Phone:
Fax:
Email:
Additional comments or explanations: __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________

NOMINATOR:
Name:
Title:
Organization:
Address:
City:
State:	Zip:
Phone:
Fax:
Email:
Nomination statement (mandatory): I believe the nominee should be Federal Library Technician of the Year for Fiscal Year 2008 because (50 words or less) __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________
Signature:	Date:

MANAGEMENT APPROVAL—Immediate Supervisor
Name:
Title:
Organization:
Statement of approval: I approve this nomination for Library Technician of the Year for Fiscal Year 2008. Comment: ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________
Signature:
Date:
MANAGEMENT APPROVAL—Second Level Manager
Name:
Title:
Organization:
Signature:
Date:

INSTRUCTIONS:

Deadlines: All nominations must be faxed no later than April 20, 2009. If a nominator does not receive confirmation of the nomination by April 27, 2009, 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 at the FLICC Forum in October 2009.