AFFILIATE JOURNAL AWARD SUBMISSION OF JOURNAL FORM

JOURNAL TITLE:

AFFILIATE'S NAME (spell out complete name, please):

CONTACT PERSON:

INSTITUTIONAL AFFILIATION:

ADDRESS:

WORK PHONE:

FAX NUMBER:

HOME PHONE:

E-MAIL ADDRESS:

NAME(S) OF EDITOR(S):

ADDRESS(ES):

1. PURPOSE OF PUBLICATION
   
   
2. STRENGTHS OF PUBLICATION
   
   
3. APPROXIMATE COST PER ISSUE
   
   
4. ANNUAL CONVENTION:  If selected, would your affiliate be responsible for having a representative on hand for the awards presentation at the Affiliate Breakfast of the NCTE Annual Convention?  (Representative is expected to purchase a breakfast ticket with conference preregistration).  YES___  NO___

          If YES, please provide name and contact information for representative:

          NAME:

          MAILING ADDRESS:

          WORK PHONE:

          E-MAIL ADDRESS:

          NAME AND COMPLETE ADDRESS OF NEWSPAPER TO BE CONTACTED:

This form and FOUR copies of one issue of the affiliate journal published between May 1 of previous year and May 1 of year of award must be postmarked and mailed to the participating SCOA Representative (Ulrich Hardt, Portland State University/GSE, P.O. Box 751, Portland, OR 97207-0751; for Federal Express or U.P.S.:  2645 N.E. Alameda St., Portland, OR  97212-1617) no later than May 1 in year of award.