Utah Arts & Museums

2014 GOVERNOR’S LEADERSHIP IN THE ARTS AWARD

- INDIVIDUAL -

This award recognizes an individual who has contributed their time and talents to enhance and strengthen the arts in their community or in the state.

Nominee must be a resident of the State of Utah

Award Nominee’s Information
Name:
Address:
City: / Zip:
Daytime Telephone: / Mobile Telephone:
Email Address:
Nominator's Information
Name:
Organization:
Address:
City: / Zip:
Daytime Telephone: / Mobile Telephone:
Email Address:


Please respond to the following questions in the space provided:

(Do not use smaller than 11 pt. type or increase the size of the tables)

1. Provide a brief description and background of nominee.
2. Describe the impact nominee’s leadership has had in the community.
3. Provide an example(s) of nominee’s leadership that enhanced and/or strengthened the arts.

Signature (Typing your full name in the signature field will be considered your electronic signature.) Date

NOMINATION FORM MUST BE EMAILED TO BY FEBRUARY 13, 2014.

Questions? Call Kirsten Darrington – 801.236.7552

2014 Governor’s Leadership in the Arts Awards - Individual 1