2019 Jean Lumb Awards - Nomination Form
Hello! You can nominate an applicant for the Jean Lumb Awards here.

A few friendly reminders:
• All nominations must be received by Monday, May 20, 2019, 11:59 pm Eastern Standard Time.
• Nominations will be kept confidential. If you would like the applicant / nominee to receive a copy of the nomination, you will receive a PDF copy of your completed nomination form via email after submission. You may send a copy to the applicant / nominee if you wish.
• Nominations and all supporting documentation become the property of the Jean Lumb Foundation.
• Jean Lumb Awards volunteers may contact you by email or phone to verify details of your nomination.
• Applicants will be notified by August 31, 2019 of the judging committee's decision.

If you have any questions or encounter any technical problems while completing this form, please email us at jeanlumbawards+support@gmail.com.

Thank you for your support and interest!

Applicant / Nominee Info
We will use this information to match your nomination with the correct application.
Preferred First Name of Applicant / Nominee *
Your answer
Last Name of Applicant / Nominee *
Your answer
Name of Applicant / Nominee's High School *
Your answer
Which category is your nominee applying for? *
Your Nomination Details
Your Full Name *
Your answer
Your Email Address *
Your answer
Primary Phone Number (e.g., 416-555-0190) *
Your answer
Secondary Phone Number
Your answer
How do you know the applicant? *
Note: Family members cannot nominate.
Your answer
Please share your reasons for nominating this applicant / nominee. If you have written a letter, please copy and paste the text into the space below. *
Your answer
Signature *
Required
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