Thomas Jefferson High School

4001 Walnut Hill Lane  Dallas, Texas 75229

RICHARD F. STROUD

DISTINGUISHED SERVICE AWARD

GUIDELINES & NOMINATION FORM

NOMINATION REQUIREMENTS

The Distinguished Service Award honors faculty and staff of Thomas Jefferson High School.  The nominee for this award must have:

A)    Served as an employee of Thomas Jefferson High School and been an exemplary leader for the students and school.

B)     Must have been employed at Thomas Jefferson High School for at least five (5) years, be at least thirty (30) years of age, and have completed his/her service to the school three (3) years past.

C)    This award may be given posthumously.

D)    Nominations may be sent in by anyone as long as the above mentioned requirements are met.

To be considered for this award, a nomination in writing must be sent to the Alumni Association at 4448 Rheims Place, Dallas, Texas 75205. When nominating, please write legibly and include a phone number or e-mail address where you can be reached so that any questions that may arise can be answered promptly.

RICHARD E. STROUD

DISTINGUISHED SERVICE AWARD

THOMAS JEFFERSON HIGH SCHOOL

NOMINATION

NAME OF NOMINEE: ____________________________________________________

YEARS OF EMPLOYMENT: ______________________________________________

ADDRESS: _____________________________________________________________

TELEPHONE NUMBER: __________________________________________________

DATE SUBMITTED: _____________________________________________________

NOMINATION STATEMENT: Please write a supporting statement including a summary of accomplishments that support this statement in the space below.  Make sure to observe the guidelines stated on the Nomination Requirement form. Use an extra sheet if necessary.

Nomination Submitted by: __________________________________________________

Address: ________________________________________________________________

Telephone Number: _________________________ E-mail ________________________

Please submit this nomination form to the Thomas Jefferson High School Alumni Association, 4448 Rheims Place, Dallas, Texas 75205.