REQUEST FOR ADDITIONAL AWARD PLAQUE(S)

Initial Plaque is Free for Each School
Plaques Should be Ordered 2 Weeks Before Needed or May 16, 2008

Cost of Each Additional Plaque is $30.00
Checks should be made payable to LI-ACS HS Awards and sent to:
Dr. Ralph Stephani
St. John's University
8000 Utopia Parkway
Jamaica, NY 11439

High School Name
Nominator Name
Nominator E-mail address
Student Name
Number of Additional Plaques  

PLEASE... Review the above data for accuracy before submitting.