John Avery Whittaker Award Nomination Form

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* 1. Your Name

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* 2. Your Email Address

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* 3. Your Phone Number

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* 4. Person Who You Are Nominating

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* 5. Person's Phone Number

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* 6. Person's Email Address (if available)

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* 7. In 30 words on less, how has this person impacted your life?

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* 8. In 30 words or less, what "Whit" qualities does this person have?

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* 9. In 30 words or less, why should this person receive the John Avery Whittaker Award?