Nomination Application – A Legacy for Nancy

Nominate Someone for this Award

Name*
First Last
Address*
Street Address City State / Province / Region ZIP / Postal Code
Phone*
Email*
Are you (or your nominee) related (either as an immediate family member or long time personal friend or business associate) to any of the board members of the Nancy Intagliata Legacy Foundation?*
Is your nominee employed at a school located in Douglas County or Littleton, Colorado?*
- Douglas County
- Littleton
Nominee's current school, position, and length of time at this position*
Please spell out school name rather than use abbreviations.
Does the nominee work at more than one school? If so, please identify all schools.*
Please spell out school name rather than use abbreviations.
Nominee's other educational employment positions held and years in these positions*
If these positions took place at other schools or workplaces, please designate.
Statement (less than 1000 words)*
Please share why you are nominating this person.
Your Name*
Your Email*
Your Phone*
Other Reference's Name*
Other Reference's Phone*
Other Reference's Email*
Upload a Picture
This is optional. JPEG and PNG files only.
Accepted file types: jpg, png, Max. file size: 512 MB.
Electronic Signature*
Date*
MM slash DD slash YYYY