WESTBURY/NEW CASSEL

NAACP IMAGE AWARDS

APPLICATION FOR HONOREES

NAACP Member Name

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PHONE _________________EMAIL ___________________________

Nominee
Name_____________________________________________

ADDRESS________________________________________________
_
PHONE_____________________EMAIL________________________
Is this person a NAACP
member Y / N
Return applications by January 23, 2010 to Carol Gardiner.
Email:Gopal7-135@att.net; Postal Mail: 178 Hopper Street,
Westbury, NY 11590

Circle One Category- EDUCATION - COMMUNITY- CIVIC

ENGAGEMENT– YOUTH- RELIGION

1-Please submit a brief biography of this person along with at least 250
words explaining why this branch should honor them with the NAACP Image
Award. Attach a separate sheet if needed.
2- Nominee should have made a significant contribution to the betterment of
our community.
3- Nominee
does not have to be a NAACP member.
does not have to be a Westbury resident.
does not have to work in Westbury.
must have a connection to Westbury via service or commitment.
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 WESTBURY/NEW CASSEL
NAACP IMAGE AWARDS
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