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VALUE Leadership Institute

Nomination Form
VALUE -- Voice for Adult Literacy United for Education

VALUE (Voice for Adult Literacy United in Education) will hold its 4 th biannual National Adult Learner Leadership Institute in Washington� D.C. on March 8�10� 2005. Through the support of the Florida Department of Education, Division of Community Colleges and Workforce Education, the Florida Adult and Family Literacy Resource Center is able to offer scholarships for two adult learners from Florida to attend.

This Institute will provide adult learners with vital information, skills, and knowledge needed to enhance the productivity of local programs throughout the United States . Participants will learn how the federal government operates, how legislators identify and address key issues, and how federal agencies and elected representatives have an impact on adult learners and their local programs. This Institute will take advantage of the resources of our nation's Capital to focus on civic education as an essential part of leadership development.

Come meet other adult learner leaders from around the country. Get information and ideas that you can take back to your program and fellow adult learners.

Scholarship recipients will be asked to write a brief essay about their experience as a participant in the Leadership Instsitute. This scholarship covers costs for travel, accomadations, and registration in accordance with state rates.

For more information on this unique opportuntity, visit VALUE's website at www.valueusa.org or contact Daniel Behnke at behnked@floridaliteracy.org or (800)-237-5113 ext. 207.

To nominate an adult learner, complete the form below and fax to Daniel Behnke at (407) 246-7104 by February 8 . On a separate page, please explain why the nominee is a good candidate, deserving of a scholarship. Please include information about any contributions this individual has made in support of his/her program, fellow adult learners, or the community. All nominations will be considered.

Organizational Representative's Name:___________________________________

E-mail: _____________________________________________________________

Organization:________________________________________________________

Address: ___________________________________________________________
Phone: _______________________________ Fax: _________________________

Student Nominated:______________Current or Former Student:______________
Length of Time in Program:_____________