Jefferson Award Form

Jefferson Awards Application

Name:

Address:

Home Phone:

Work Phone:

The following sentence needs to be completed. Please limit your essay to 500 words - see questions below for assistance in writing this response: “This individual is nominated for a 2007 Jefferson Award for Public Service because… “

Please use the following questions to help assist you while writing the biography:

1.How has this nominee impacted the community?

2.How many years has this nominee given of his/her time and resources to help the community? (Please include all the years the person has helped the community even if their nomination focuses on a specific project).

3.What makes this individual deserving of the Jefferson Award for Public Service?

4.Is this service-volunteered work or a paid position?

Please complete and return, by Friday, February 16, 2007 to:

Cheron Porter

Director of Community Affairs

ABC 2 – WMAR – TV

6400 York Road

Baltimore, MD 21212