TELLING OUR STORIES / MAKING A DIFFERENCE NOMINATION FORM 6th Annual Greater Hartford STARS Student/Teacher Achievement Recognition Salute Thursday, April 9, 2015 Hartford Public Library Center for Contemporary Culture 500 Main Street, Hartford 5:30 - 7:30pm Light refreshments: 5:30 pm / Program: 6-7 pm / Networking: 7-7:30 pm Free parking available behind the library in the Sheldon Street parking lot. For more information, contact David Hendricks (860) 707-6585, Leonie Parks (860) 922-0080 or Estela Morales (860) 543-2107 Your program may nominate TWO learners/former learners. You may choose students that have shown strong academic achievements, played a leadership role with their classmates or in your program, or both! Your program may nominate ONLY ONE teacher/staff member (Please choose one teacher/staff to represent your program). --------------------------------------------------------------------------------------------------------------------Return this form via email to Dana Little at [email protected] by Friday, March 13, 2015. These descriptions will be included in a program booklet to be given out at the event. If there are questions, please contact Dana Little via email or at (860) 524-4054. Program Name: ________________________________________________________ Program Address: _____________________________________________________ Contact Name: ________________________________________________________ Phone: (_____)_____________ Email: _____________________________________ a. Adult Learner (s) to be honored (please write no more than 100 words about why this learner is being honored): b. Teacher/Staff member to be honored (please write no more than 100 words about why this teacher/staff is being honored): Note: If the learner and teacher/staff selected have a special relationship, please feel free to write about that as well.
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