Mortensen Award Form 09 by D5D29A5


									MISAC Nomination Form For The:

                      2009 Carol Mortensen
               Invasive Species Management Award
Please type or print:

1. Nominee Information
Nominee’s Name:
                        First           Last            Middle (maiden, if appl.)

Affiliation (if applicable.):

                        Street          City            State          Zip Code

Work Phone:                                             Email:

Preferred salutation (please circle):   Mr.    Mrs.     Ms.      Dr.   Other:

2. Nominee’s Work Experience:
Employer                         Dates of             Position

3. Provide a BRIEF description of the nominee’s accomplishments or
contributions to invasive species efforts in Minnesota based on one or
more of the criteria below. (Target 300 words or fewer per category).

  a.) Improving cooperation and coordination among invasive specie partners.
b.) Raising awareness of invasive species including innovative educational

  c.) Significant contributions to prevention, management or control of invasive
4. Nominator:
               First                  Last            Middle (maiden, if applicable)


               Street                 City            State         Zip Code

Work Phone:                                  Email:

Relationship to Nominee (if applicable):

5. Attachments
Attach any materials that document the nominee’s achievement or accomplishments.
These may include: vita, clippings, publications, reports, or performance summations
relevant to understanding the nominee’s qualifications and achievement for the award.
Up to three letters of support from collaborators, supervisor, co-worker or colleague are
strongly encouraged. Please list all attachments below:

Note: If nominee is not selected for the award in this round, their nomination will be kept
active for the next two years for further consideration. During that time, previous
nominations may be updated if the nominators feel doing so would significantly improve
the nomination, but past nominators are not required to do so.

Postmark, email or fax date: November 30, 2009.

Mail, fax, or Email completed nomination form and attachments to:
Jean Swanson
Agronomy and Plant Genetics
411 Borlaug Hall
St. Paul, MN 55108
Phone 651-625-2740
Fax 651-625-1268

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