The Potato Association of America

Outstanding Extension Project Award

Project or Program Title: 

Project Authors or Coordinators:

Institution:

Address:

State/Province

Zip

Phone: 

Email:

Project, Program Audience, Highlights, Impacts, Outcomes:

Nomination Supporters:

Name:

Address:

Phone:

Email:

Name:

Address:

Phone:

Email:

Nominator Name:

Address:

Phone:

Email:

Signature:

On a separate sheet include a written review of project's or program's contribution and/or impact to potato education through Extension. Written nominations are not to exceed 1,000 words.