Society of North Carolina Archivists

Gene J. Williams Award

Nomination Form

SECTION ONE (To be completed by the Student) Social Security No:

NAME:_______________________________________________________________________

PERMANENT ADDRESS:_______________________________________________________

_________________________________________TELEPHONE:________________________

LOCAL ADDRESS:_____________________________________________________________

_________________________________________TELEPHONE:________________________

E-MAIL ADDRESS:____________________________________________________________

GRADUATE STUDENT DEPT.:__________________________________________________

COLLEGE OR UNIVERSITY NAME:______________________________________________

TITLE OF PAPER:______________________________________________________________

______________________________________________________________________________

NUMBER AND TITLE OF COURSE:______________________________________________

SEMESTER PAPER WAS WRITTEN: _________________________YEAR:______________

FACULTY MEMBER TO WHOM PAPER WAS SUBMITTED:_________________________

SECTION TWO (To be completed by faculty member)

The above information concerning the paper, course, and semester is correct.

The paper was prepared as part of a course or independent study project

taken for credit at the institution designated.

Date:___________________________Faculty Member:________________________________

Submission forms and papers should be sent to:

Gene J. Williams Award
c/o SNCA
Post Office Box 20448
Raleigh, NC 27619