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Nomination Form
Richard E. Walker Award
Oregon Safe Schools and Communities Coalition
PURPOSE: To recognize an individual or organization that has made a significant contribution to
furthering the mission of OSSCC.
The Oregon Safe Schools and Communities Coalition (OSSCC) seeks to create
safe schools and communities where every family can belong, every educator can
teach, and every child can learn regardless of actual or perceived sexual orientation
or gender identity. The OSSCC believes that all youth deserve to feel safe and welcome
in our schools and communities. We seek to achieve this mission in three ways:
1) Education, 2) Data Collection, and 3) Support Services.
PRESENTED: At OSSCC Annual Meeting in May 2010.
Please complete all of the following for consideration.
NOMINEE'S NAME:
NOMINEE'S ADDRESS:
NOMINEE'S PHONE NUMBER AND EMAIL ADDRESS:
NOMINATED BY (INCLUDE YOUR NAME, PHONE NUMBER AND EMAIL ADDRESS):
NOMINATION RATIONALE (In 250 words or less, please answer these questions on a separate sheet):
- In what capacity do you know the nominee?
- How has the nominee furthered the mission and work of the OSSCC?
- Provide examples of the nominee's background that shows commitment to the GLBTQ community.
Consider the following:
a. present and/or past employment
b. years of experience related to the purpose of this award
c. years of service to the GLBTQ community
d. specific projects the nominee has worked on
e. contributions the nominee has made to advance the mission of OSSCC
f. other pertinent information such as previous awards, honors, etc.
- Additional information that demonstrates ways in which the nominee has worked toward the
health and safety of GLBTQ youth.
The above information will be used in selecting the award recipient, in presenting
the award and in media announcements. Therefore accuracy and completeness is important.
Nominations without complete information will not be considered.
To be considered, your entry must be received no later than April 1, 2010.
Send to: OSSCC
PO Box 80604
Portland, OR 97280
For questions, call, 503-954-4865, or email, info@oregonsafeschools.org
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