Name of Group or Individual Making the Nomination: *
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Contact Address: *
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Contact Phone Number: *
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Nominee: *
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Holt Public Schools Current Position: *
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Total length of tenure in all positions at Holt Public Schools: *
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Describe the nominee's significant contribution to and its impact on Holt Public Schools in his/her/their employment capacity, citing specific examples where possible: *
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Holt Public Schools Past Employment as:
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Provide examples of how his/her/their involvement with Holt Public Schools as a school employee or as a community member and/or volunteer has provided significant additional impact: *