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      Levine Medal Nomination Application

      Please fill out the application completely then click on submit.

   
Name:
Address:
Phone Number:
E-mail Address:
Occupation:

1. How do you interpret self-education?


2. For not having obtained a college degree, how did you get into the field you're currently in?


3.
Do you think not obtaining a college degree is detrimental to furthering your career? Please explain.


4.
What steps did you take to achieve the goals you set for yourself?



5. What kept you motivated and determined?


6. Would you endorse self-education to students in their last year of graduating high school? Why or why not.


7. What life lesson do you model your life by?


8. Who do you consider your mentor and why?

9. What books have influenced you and why?

10. In what ways have you applied your self-educated knowledge for the betterment of our society?

11. Who did you find to be the most influential individual of our time and why?

12. What would you like your legacy to be?