NALC/Polaroid
"LOCAL MEMBER OF THE YEAR"
Application
NOMINEE'S NAME_________________________________________________________
Address____________________________________________________________________
City_____________________________________ State _______________Zip____________
Telephone________________________________
Office Address_______________________________________________________________
City_____________________________________ State _______________Zip____________
Office Telephone________________________________
Litho Club Member Since___________
Nominee's ingenuity and creativity that have benefited the local club:_______________________
__________________________________________________________________________
__________________________________________________________________________
Nominee's extraordinary skill in the performance of club duties:___________________________
__________________________________________________________________________
__________________________________________________________________________
Nominee's reliability and length of service:___________________________________________
__________________________________________________________________________
__________________________________________________________________________
Nominee's other accomplishments that benefited the litho club:___________________________
__________________________________________________________________________
__________________________________________________________________________
Submitted by:________________________________________________________________
Litho Club:__________________________________________________________________
Date:______________________________________________________________________
Complete form and all information by NOVEMBER 30 and send to:
JR Westland
c/o NALC Awards
15421 Old Columbia
Pike
Burtonsville, MD 20866
(301) 384-7700 - FAX (301) 384-2616