ISLMA Nomination and Application Form

Please check only one:

Polestar Award

ISLMA/Upstart Award

Nominee:
Name:
Position:
Address:
Home:
Phone:
Library:
Phone:
Fax:
E-mail:

Statement(s) of Support: Address all criteria as outlined in the awards section of the
membership directory. Attach all statements, letters, documentation, etc., as directed in
the criteria.

Nominator:
Name:
Position:
Address:
Home:
Phone:
Library:
Phone:
Fax:
E-mail:

Return completed form with all statements of support, criteria, etc to: Awards Chair, ISLMA, P.O. Box 598, Canton, Illinois 61520. Form may be photocopied or reproduced on a word processor.