Friends of Extension Nomination 2012 Any ISUE or county employee may submit nominees for state consideration Deadline for submission is March 31, 2012 Submit as an e-mail attachment to Carol Peterson at email@example.com (only e-mail nominations will be accepted) Length of nomination is not to exceed 2 typed pages. Sponsored by the Iowa Chapter of Epsilon Sigma Phi Name:________________________ Phone:_________________________ Address:________________________________________________________ Please specify if this is an individual ______ couple______ business_______ 1. Give a brief description of the applicant's contributions to Extension programs both past and present: 2. What happened as a result of the applicant's efforts in relationship to Extension? 3. General information about the applicant's family, community services, activities. Contact person(s) submitting the application: _______________________________ E-mail:______________________ Phone: _______________________ Note: If your nominee is an award recipient, we will need 2 electronic photos of the nominee.
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