Submitted by:                                                                       *  Date:                                          

*must be a PLT facilitator, steering committee member or state coordinator. 

I hereby nominate                                                                     School as a Louisiana Project Learning Tree Certified School.

This school has met all the criteria necessary to be recognized as a Louisiana Project Learning Tree Certified School, having at least 50% of its teaching faculty trained. The school has prepared and submitted their project, documenting use of PLT throughout the academic year.

                                                                is the school’s designated coordinator and has been active in overseeing the school’s treemendous PLT project and has prepared the attached project documentation.

If approved, please provide                                                         School with the Louisiana Project
Learning Tree Certified School sign, the plaque, coordinators shirt and other items for presentation on

                                               (Please allow two months from date of nomination)

I hereby certify that                                                     school has met or exceeded the standards set for a Louisiana Project Learning Tree Certified School.

Signature                                           Name (printed)                                            

Address                                            
 City Parish

Telephone                                           

I                                            , Principal of                                            School in the

                                           School district, certify that this school has met or exceeded all the criteria for a Louisiana Project Learning Tree Certified School, and that we have and endeavor to

continue yearly PLT activities under the leadership of                                            , our designated school PLT coordinator (or other designated school PLT coordinator). We have a teaching staff

of                      Teachers of which                      are trained.

Signature                                                                  Date                                         

Printed Name                                                             Address                                               

Please provide the following documentation when submitting this form:

• a list of teachers who have completed a 6 hour PLT workshop and dates each attended;
• pictures, videos, student work, or other artifacts showing how PLT was used during the school year; and
• cover sheet providing school name, address, phone number, e-mail (optional), school coordinator, principal, and brief description of the on-going project.

Send the completed form and documentation to the following address:

                        LA PLT
                        Department of Agriculture and Forestry
                        P.O. Box 1628
                        Baton Rouge, LA  70821-1628