Issue link: http://digital.copcomm.com/i/610158
24 ADVOCATE | WINTER 2015/16 2016 Especially for Kids Award Nomination Form ESProfessional 1. Nominee's name ___________________________________________________________________________________________________________________ (If a group of people is being nominated rather than an individual, or an ESP affiliate, please attach their names on a separate piece of paper.) Nominee's school district ___________________________________________________________________________________________________________ Nominee's address _________________________________________________________________________________________________________________ City _______________________________________ State _________________ ZIP ____________________________________________________________ Home Phone (______) _________________________________ Work Phone (______) __________________________________________________________ Position ___________________________________________________________________________________________________________________________ Responses to questions 2-5 may be handwritten or typed and attached to the nomination form. 2. Describe what the nominee does ESPecially for Kids. In what ways does the nominee interact with the children that makes him or her specially qualified for the award beyond their daily routine of activities and job description? 3. Describe the kind of students who are helped by the nominee. What are the specific group, grade, and ages of the children involved? 4. In describing how students benefit from the nominee's efforts, list details to demonstrate how the service benefits the children. 5. Thoroughly explain the operations of the program(s) being administered. Give concrete examples. 6. Be sure the following information is completed in full. Nominator's name _________________________________________________________________________________________________________________ Nominator's address ______________________________________________________________ City _________________ State _____ ZIP ____________ Home phone (______)_________________________________ Work phone (______)________________________________ 7. Nominee's local association__________________________________________________________________________________________________________ 8. President of nominee's local association _______________________________________________________________________________________________ 9. I attest that the nominee(s) is a/are member(s) in good standing. Signature of local president __________________________________________________________________________________________________________ 10. List the names, positions and phone numbers of at least two people who are willing to be contacted as references about the nominee(s). 1. ________________________________________________________________________________________________________________________________ 2. ________________________________________________________________________________________________________________________________ 3. ________________________________________________________________________________________________________________________________ Entries must be submitted or postmarked no later than Friday, February 29, 2016 to: AEA (ESP Award), Chris Mayer, 345 East Palm Lane, Phoenix, Arizona 85004 or FAX (602) 240-6887.