The Gleitsman International Activist Award PDF Print E-mail
The 2009 Gleitsman International Activist Award will honor an activist who has struggled to correct social injustice in the world (citizen activists are the focus of our award in alternate years). The honoree will receive $125,000 and will receive a specially commissioned sculpture designed by Maya Lin, creator of the Vietnam War Memorial in Washington, DC. The award is not presented posthumously, nor is it granted to groups or organizations.

Please complete this nomination form and forward it with supporting materials to us postmarked not later than April 17, 2009.
*  Nominee:
*  Organization:
*  Address:
*  City:
*  State/Province:
*  Country:
*  Zip Code/Postal Code:
*  Telephone:
*  Fax:
*  Email:
*  Website:
Our Board of Judges will assess the merits of your nominee based on the materials which you provide and your responses to the questions below. It is essential that you submit all background information, including newspaper and magazine articles, letters of recommendation etc. Please do not forward videos, DVD's, CD's, books, or materials bound in plastic. Self nominations cannot be considered.

Please be sure to include the following information:
*  1. Describe what has motivated our nominee to make a difference:
*  2. What steps has your nominee taken to bring about change:
*  3. Describe the impact your nominee's actions have had on our lives:
Please list two references for your nominee:
  Reference 1:
*      Name:
*      Telephone:
  Reference 2:
*      Name:
*      Telephone:
*  How did you receive this nomination form? (Internet, email, etc.):
The undersigned grants to the Gleitsman Program for Leadership in Social Change at Harvard Kennedy School the right to copy, reprint, quote or publish the above information as part of its awards program or other public communication. Nomination materials become the property of the Gleitsman Program for Leadership in Social Change at Harvard Kennedy School and will not be returned.
*  You may list my name as an International Activist Award Nominator:

*  Your Name:
*  Affiliation:
*  Address:
*  City:
*  State/Province:
*  Country:
*  Zip Code/Postal Code:
*  Telephone:
*  Fax:
*  Email:
*  Website:
Please submit all supplemental materials to the following address by Friday, April 17th, 2009:

Gleitsman International Activist Award
Center for Public Leadership
Harvard Kennedy School
79 John F. Kennedy Street
Mailbox 124
Cambridge, MA
02138
 
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