1. Nomination Form
    2. Service Information:
      1. The entry can be either mailed, faxed or emailed
      2. Governor’s Mentoring InitiativeEmail: Cristal.Col
 
 
Governor’s Mentoring Initiative
Award of Excellence
 
 
The Governor’s Mentoring Initiative Award of Excellence will be given to a school-based mentor
who has demonstrated service above and beyond.
 
Award Guidelines
Nominees may be considered for having overcome barriers on behalf of themselves or their
student, mentoring multiple students over a long period of time, or providing exemplary service to
a mentoring program. All nominations should include specific information on how the mentor
has assisted a student in making a significant achievement in academics, attendance and/or
behavior
.
 
One mentor of excellence will be selected from each of the five Department of Education regions
in the state of Florida.
 
The Award
Each selected mentor will receive a vacation cruise for two donated by Carnival Cruise Lines.
 
Winners will stay in a luxurious 1,100 square foot Presidential Suite!
 
 
Special Rules
Nominees must be 18 years or older. Those selected between the ages of 18 and 21, must be
accompanied by a parent or legal guardian.
 
  
 
 
The Award of Excellence is brought to you by:
 
 
 
Nomination Form
 
 
Program:
___ BB/BS ___ CHAMPS ___ HOST ___ TSIC ___Youth Motivators ___ Other
 
  
  
  
  
  
  
  
Nominator Information:
 
___Mr. ___ Mrs. ___ Ms.
Name: _______________________________________________________________
 
Address: ______________________________________________________________
 
City: _____________________________ ZIP: _______________County: ____________
 
Phone: ____________________Email: _______________________________________
 
 
Nominee Information:
 
___Mr. ___ Mrs. ___ Ms.
Name: ________________________________________________________________
 
Address: ______________________________________________________________
 
City: ______________________________ ZIP: ___________Age/Grade: ____________
 
Phone: ______________________Email: _____________________________________
 
Service Information:
 
Name of School/Organization: _______________________________________________
 
Number of years as a mentor? _____________
 
 
On a separate page, tell us why your nominee deserves
the Governor’s Mentoring Initiative Award of Excellence:
(This should be no more than one-page, single-spaced)
 
 
The entry can be either mailed, faxed or emailed as an attachment…
Return to: Fax: (850) 487-1866
Governor’s Mentoring Initiative Email: Cristal.Cole@myflorida.com
909 The Capitol
Tallahassee, FL 32399 Deadline: January 24, 2003
 
 

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