The Shelley Fralic Award - Application Form

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First Name

First name of the person filling out the nomination form

Last Name

Last name of the person filling out the nomination form

Email Address

Email address of person filling out the nomination form

Phone Number

Phone number of person filling out the nomination form.

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

First Name of person being nominated

Last Name of person being nominated

Phone number for nominee

Email address for nominee

Nominee's Current Resume

Click or drag a file to this area to upload.

Upload the nominee’s current resume.

Précis

Click or drag a file to this area to upload.

Upload a 50-word précis explaining why the nominee merits consideration for the award.

Synopsis

Click or drag a file to this area to upload.

Upload a synopsis of no more than 500 words, outlining the candidate’s attributes and accomplishments as a journalist, and their accomplishments and impact on their communities, the people, and the world around them (see eligibility section of this website, last two bullet points).

Letters of Support

Click or drag files to this area to upload. You can upload up to 2 files.

Upload two letters of support from people who endorse the nominee for this award, including contact information of each person, their phone number and email address. The person filling out this nomination form may be one of these people providing a letter of support.

I declare that all the information provided in this application is true and correct.

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