Form LD A211 "Volunteer Tutor Nomination Form" - Illinois

What Is Form LD A211?

This is a legal form that was released by the Illinois Secretary of State - a government authority operating within Illinois. As of today, no separate filing guidelines for the form are provided by the issuing department.

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Download Form LD A211 "Volunteer Tutor Nomination Form" - Illinois

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JESSE WHITE • Secretary of State & State Librarian
Illinois State Library, Gwendolyn Brooks Building
300 S. Second St., Springfield, IL 62701-1796
Illinois State Library
SPOTLIGHT ON SERVICE AWARDS
Presented by the Illinois Secretary of State/State Librarian Jesse White
Nomination Information
1. An adult literacy volunteer tutor may be nominated by the following:
• An adult learner who has worked with the tutor during the previous calendar year January-December;
• A literacy staff person in the current program; or
• Another adult volunteer tutor in the current literacy program.
2. You may want to nominate a volunteer tutor who has devoted many hours to tutoring, who uses creative methods to
reach difficult learners, who time and again has gone the extra mile for the learners, or whose story is particularly inspir-
ing. If you think he or she deserves an award, then go ahead and nominate that volunteer tutor. If you have questions,
don’t hesitate to call our office.
3. Americorps Vista volunteers are paid and therefore are not eligible for a Spotlight on Service nomination. Spotlight on
Service nominees must not receive payment for their volunteer tutoring.
4. Persons cannot win the Spotlight on Service Award more than once. The previous nominee may be re-nominated if
he/she is currently still volunteering in the nominator’s program.
5. This form may be duplicated and used to nominate multiple adult volunteer tutors.
6. All forms must be completed in English.
7. The top Illinois adult literacy volunteer tutors will be selected by a panel of literacy advocates. Winners are chosen on
the basis of their stories as presented through the nomination materials.
8. Spotlight on Service Award winners will be notified in April and recognized at an event at the State Library in Springfield
in May where they will receive a plaque of achievement. Sponsoring literacy agencies will receive $550 per winner to
cover travel expenses to and from the event. Remaining award funds must be used to support the literacy project at
the sponsoring agency.
9. Once the awards have been made, a release will be provided by the Illinois State Library Literacy Office to the winner
that must be signed and returned. This will allow the Secretary of State/Illinois State Library and community publica-
tions to use the winner’s name, picture and story relating to the Spotlight on Service Awards.
10. PLEASE EMAIL NOMINATION FORMS NO LATER THAN MARCH 15 to literacy@ilsos.net.
For additional information, please call Tom Huber at
217-524-3005 or 800-665-5576, #3, or thuber@ilsos.net.
1
Printed by authority of the State of Illinois. November 2018 – 1 – LD A 211.6
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Save
Email
JESSE WHITE • Secretary of State & State Librarian
Illinois State Library, Gwendolyn Brooks Building
300 S. Second St., Springfield, IL 62701-1796
Illinois State Library
SPOTLIGHT ON SERVICE AWARDS
Presented by the Illinois Secretary of State/State Librarian Jesse White
Nomination Information
1. An adult literacy volunteer tutor may be nominated by the following:
• An adult learner who has worked with the tutor during the previous calendar year January-December;
• A literacy staff person in the current program; or
• Another adult volunteer tutor in the current literacy program.
2. You may want to nominate a volunteer tutor who has devoted many hours to tutoring, who uses creative methods to
reach difficult learners, who time and again has gone the extra mile for the learners, or whose story is particularly inspir-
ing. If you think he or she deserves an award, then go ahead and nominate that volunteer tutor. If you have questions,
don’t hesitate to call our office.
3. Americorps Vista volunteers are paid and therefore are not eligible for a Spotlight on Service nomination. Spotlight on
Service nominees must not receive payment for their volunteer tutoring.
4. Persons cannot win the Spotlight on Service Award more than once. The previous nominee may be re-nominated if
he/she is currently still volunteering in the nominator’s program.
5. This form may be duplicated and used to nominate multiple adult volunteer tutors.
6. All forms must be completed in English.
7. The top Illinois adult literacy volunteer tutors will be selected by a panel of literacy advocates. Winners are chosen on
the basis of their stories as presented through the nomination materials.
8. Spotlight on Service Award winners will be notified in April and recognized at an event at the State Library in Springfield
in May where they will receive a plaque of achievement. Sponsoring literacy agencies will receive $550 per winner to
cover travel expenses to and from the event. Remaining award funds must be used to support the literacy project at
the sponsoring agency.
9. Once the awards have been made, a release will be provided by the Illinois State Library Literacy Office to the winner
that must be signed and returned. This will allow the Secretary of State/Illinois State Library and community publica-
tions to use the winner’s name, picture and story relating to the Spotlight on Service Awards.
10. PLEASE EMAIL NOMINATION FORMS NO LATER THAN MARCH 15 to literacy@ilsos.net.
For additional information, please call Tom Huber at
217-524-3005 or 800-665-5576, #3, or thuber@ilsos.net.
1
Printed by authority of the State of Illinois. November 2018 – 1 – LD A 211.6
SPOTLIGHT ON SERVICE AWARDS
Volunteer Tutor Nomination Form
PLEASE TYPE
ADULT LITERACY VOLUNTEER TUTOR NOMINEE:
TITLE (Mr., Ms. or Mrs.)
___________________________________________________
FIRST NAME
___________________________________________________
LAST NAME
___________________________________________________
ADDRESS
___________________________________________________
CITY
___________________________________________________
ZIP CODE + 4
___________________________________________________
TELEPHONE
___________________________________________________
EMAIL OF NOMINEE
___________________________________________________
LENGTH OF TIME VOLUNTEERED AS AN
ADULT LITERACY TUTOR
___________________________________________________
LENGTH OF TIME ADULT LITERACY VOLUNTEER
TUTOR HAS BEEN AT THIS LITERACY PROGRAM
___________________________________________________
AGENCY NAME:
___________________________________________________
CONTROL# AND BRANCH#
___________________________________________________
ADDRESS
___________________________________________________
CITY
___________________________________________________
ZIP CODE + 4
___________________________________________________
TELEPHONE
___________________________________________________
FAX
___________________________________________________
PROGRAM CONTACT PERSON
___________________________________________________
EMAIL
___________________________________________________
NAME OF NOMINATOR:
___________________________________________________
RELATIONSHIP TO NOMINEE
___________________________________________________
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SPOTLIGHT ON SERVICE AWARDS
TO BE COMPLETED BY NOMINATOR
PLEASE TYPE
(Limit response to this page and one (1) attached page.)
NAME OF NOMINATOR: ____________________________________________________________________________
NAME OF ADULT LITERACY
VOLUNTEER TUTOR BEING NOMINATED: _____________________________________________________________
REASONS ADULT LITERACY VOLUNTEER TUTOR DESERVES NOMINATION:
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SPOTLIGHT ON SERVICE AWARDS
The following narrative is to be TYPED BY THE ADULT LITERACY VOLUNTEER NOMINEE. Describe why you volunteer
as a literacy tutor. Describe any specific instances or students that have been rewarding or challenging for you as a literacy
tutor.
(Limit response to this page and one (1) attached page.)
NAME OF ADULT LITERACY
VOLUNTEER WRITING NARRATIVE: __________________________________________________________________
4