Illinois Business Education Association :: Writers' Hall of Fame Submission

ILLINOIS BUSINESS EDUCATION ASSOCIATION

Writers' Hall of Fame Award Submission Form

PERSONAL INFORMATION

Type of Application: Writers' Hall of Fame Award

Name of Writer

Home Address

City

State Enter the two-letter state abbreviation only.

Zip Code

Work Phone Please enter in the format: +1(XXX)XXX-XXXX

Home Phone Please enter in the format: +1(XXX)XXX-XXXX

E-mail Address

Biographical Information

Title of Article

Name of Journal (magazine, proceedings, etc.):

Publication Date Enter the date in the format: mm/dd/yyyy

Volume & Issue Number

Other Information

By clicking the Submit button below, I agree that the information which I have stated on this Award Application is true to the best of my knowledge. I understand that any information that is not true will disqualify me for consideration for the award for which I have been nominated and am applying.

I also understand that by clicking the Submit button, that I am sending an application via e-mail to the IBEA Awards Chairperson to apply for the award referenced above to be awarded at the current year's IBEA Fall Conference.

A copy of this form submission will be e-mailed to you, the IBEA Webmaster, and stored in the IBEA Website database

When you click the Submit button, your form will be processed. A successful form submission will redirect you to the home page of the IBEA website. If you receive a page of errors, please contact the Webmaster at webmaster@ibea.org.