Georgia Association of Family and Consumer Sciences

AWARD APPLICATION
One copy must accompany each application and must be word processed
Do not add additional pages to this form

NAME OF GAFCS AWARD APPLYING FOR:

JULIUS BENTON PROFESSIONAL IMPROVEMENT AWARD

WILEY-BERGER AWARD FOR VOLUNTEER SERVICE

OUTSTANDING FAMILY AND CONSUMER SCIENCES PROFESSIONAL

GEORGIA NEW ACHIEVER AWARD

GEORGIA LEADERS AWARD

GEORGIA TEACHER OF THE YEAR

PERSONAL INFORMATION

NAME AS IT SHOULD APPEAR ON AWARD:

MAILING ADDRESS:

CITY:

STATE: ZIP CODE:

HOME NUMBER: CELL NUMBER:

EMAIL ADDRESS:

AAFCS MEMBERSHIP NUMBER: Number of Membership Years

APPLICANT SIGNATURE:

30 WORD SUMMARY DESCRIBING YOUR

AWARD ENTRY:

Official Use Only:

Award Winner (Circle One): YES NO

Approved by VP of Awards & Recognition:

Date:

Monetary Award Amount: GAFCS Check Number: