PLEASE NOTE
  • Nomination can be either by the candidate or someone else
  • If you are submitting for yourself, please fill in your information in BOTH the submitters information as well as the candidates information
  • Deadline: Tuesday February 4, 2014, 4 Adar I

Submitter's Information

Name



Email

Phone Number

Submitter's Relationship
with Candidate

words. Please limit to 50 words or less.

Candidate's Information

Name



Email

Phone Numbers




About the Candidate

In 500 words or less, please describe why the candidate you are nominating deserves the "Lion of Zion" Moskowitz Prize for Zionism.*

words. Please limit to 500 words or less.

References

A minimum of one reference is required in order to complete the nomination process. Additional references may be added below.

Reference #1

Name



Position

words. Please limit to 50 words or less.

Relationship to the Nominee

words. Please limit to 50 words or less.

Email

Phone Numbers





Reference #2

Name



Position

words. Please limit to 50 words or less.

Relationship to the Nominee

words. Please limit to 50 words or less.

Email

Phone Numbers





Reference #3

Name



Position

words. Please limit to 50 words or less.

Relationship to the Nominee

words. Please limit to 50 words or less.

Email

Phone Numbers





Reference #4

Name



Position

words. Please limit to 50 words or less.

Relationship to the Nominee

words. Please limit to 50 words or less.

Email

Phone Numbers






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