Arizona Education Association

Winter 2016

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20 ADVOCATE | WINTER 2016 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. ______________________________________________________________________________________________________ DEADLINE: MARCH 1 ESP Award MAIL EMAIL FAX Attn: Chris Mayer Arizona Education Association 345 East Palm Lane Phoenix, AZ 85004 602-240-6887 chris.mayer@arizonaea.org ESPecially for Kids Award n

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