Louis E. Yavner Citizen Award for 2009

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The Board of Regents invites nominations for the Louis E. Yavner Citizen Award for 2009 to recognize a citizen who has made an outstanding contribution to education about the Holocaust and other violations of human rights. This annual award was established by the Regents and funded by the late Regent Emeritus Louis E. Yavner to honor Holocaust survivors, scholars of the Holocaust and human rights issues from many professions, and self-taught experts who help to educate New York State students about these difficult topics. Elementary and secondary teachers and State Education Department staff are not eligible for this award. Awards are presented to residents or nonresidents on the basis of their distinguished educational service to local, regional, and/or State institutions and organizations through classroom and public programs, school assemblies, workshops, exhibits, community service, scholarship, writings, and other related activities. The following nomination application lists award criteria. Please note that documentation must be provided to support the scope, breadth, quantity, and quality of the nominee's work. The deadline for submission of nominations is Friday, January 29, 2010. The award winner will be notified in April 2010, with the name remaining confidential until the award ceremony in May 2010.

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Nominee Information

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* Full Name of nominee:

* Title of nominee:

Business Information

* Address of nominee:

* City:
* State:	Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tenessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
* Zip Code:

* Telephone: Ext:

* E-mail:

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Home Information

Address of nominee:

City:
State:	Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tenessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip Code:

Telephone: Ext:

E-mail:

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Nominator Information

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* Full name of nominator:

* Title of nominator:

Business Information

* Address of nominator:

* City:
* State:	Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tenessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
* Zip Code:

* Telephone: Ext:

* E-mail:

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Home Information

Address of nominator:

City:
State:	Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tenessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip Code:

Telephone: Ext:

E-mail:

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Names, Email Addresses, and Telephone Numbers
of other people who could be contacted in support:

1. * At least one contact is required
   
   
2. Name:
   Email:
   Phone: Ext:

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10. Name:
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AWARD CRITERIA:

The nominee's work related to the Holocaust and other violations of human rights on a local, regional, and/or statewide basis will be judged according to the following criteria:

• Range of activities in public and/or nonpublic schools
• Range of activities outside of school, such as contributions which have benefited professional associations, higher education institutions, cultural institutions, civic groups, and/or service organizations
• Degree of quality
• Number of students, teachers, and others reached
• Sufficient documentation

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DOCUMENTATION:

Documentation must be provided that supports the criteria listed above.
Click on the Continue button to begin uploading documents. Do not click on continue if you are not ready to upload your documents, as you will only be able to fill out this form once.

I declare and affirm that the documentation submitted are to be true, complete, and accurate. I do authorize the New York State Education Department to review said documentation for the purpose of the Louis E. Yavner Award selection process only.