The winner will receive recognition and a matted, framed certificate at the FSNA Industry Seminar.

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Each year, FSNA honors school foodservice nutrition professionals with the Leadership Award. This award recognizes an individual who has applied his or her leadership skills, creative approach to leadership, and/or successful completion of an Association project. Background School Foodservice Nutrition professionals use their expertise to lead their fellow professionals in the child nutrition industry whether it is through the promotion of membership and certification; communication with the chapter members through email, phone calls, mailings, or activities; or demonstrating outstanding support for the children in the community and/or nutrition program. Who May Apply Nominations may be submitted by the person s supervisor, staff, or fellow school foodservice nutrition professional. This person must be a SNA certified and/or credentialed member and a member of FSNA. The nomination should be based on how well the nominee has shared their foodservice knowledge/expertise with their peer members. Nominations should be written so that the nominee s name does not appear throughout the entry. The nominee s name should only appear on the top page of the nomination form and any accompanying documentation so judging is as objective as possible. Even if you have submitted an award in the past, do not start until you have read the General Information and Procedures, Award Application Process. This is important in making sure you are following the criteria required for the award process and they may have changed from the previous year. Selection Procedure The application must be postmarked on or before August 1 of each year and sent to the FSNA Scholarships and Awards Chair. Judging will be based on previously stated criteria. All documentation must be neatly bound in a 1 or smaller folder/binder, on one-sided 8 ½ x 11 paper with the completed entry form serving as the cover page for all documentation. Recognition The winner will receive recognition and a matted, framed certificate at the FSNA Industry Seminar. Judging Judging to be done by S&A Chair, A/S Chair and President-Elect at the August Board meeting. 1

Name of Person Nominating: Nominee: Title: Employer: LEADERSHIP AWARD Address: Street or PO Box: City: State: Zip Code: County/Chapter: Region: Signature: Date: Business Address of Nominator: Street or PO Box: City: State: Zip Code: Home #: Business #: Cell #: Email: 2

Explain reason(s) why you have nominated this individual for this award. You may attach additional supporting documentation if needed. 3

Checklist of Person Submitting Nomination This is for use by person preparing and submitting an award. Its use is strictly optional and must not be submitted with the award. ACTIVITY TO COMPLETE AWARD ENTRY DATE COMPLETED OR CHECKED COMMENTS Met General Qualifications Copy of FSNA/SNA Current Membership Cards or verified by state office Copy of SNA Current Certification/Credentialed Card or verified by state office Signatures Spelling and Grammar Checked Award Qualifications Year of Award New Award (Not previously submitted) Timetable Award sent to S & A Awards Chair postmarked on or before August 1 Requirements for Award Official format used and all sections completed Number of one-sided documentation pages included with entry form Neatly bound in a 1 or less folder/binder (onesided) 4

VERFICATION AND JUDGING FORM To be filled out by Scholarships and Awards judges only Name of Entrant/Nominee County FSNA Region School Small Medium Large N/A Verification: Yes No N/A FSNA Membership SNA Membership Certification/Credentialed Format Binder no larger than 1 Signatures Postmark Deadline Note: Review the award for qualifications and check appropriately. A no in any required area above may disqualify the entry. Judging Scale: None = 0 Fair = 1 Good = 2 Very Good = 3 Outstanding = 4 Rating Documentation (pictures, news articles, etc.)... Quality of content... Specific goals and objectives stated and achieved... Involvement of stakeholders (students, parents, etc.)... Promotes and achieves purpose of award... Total Score (possibility of receiving 20 points)... Judge s Comments: Judges Initials Date 5