Issue link: https://digital.copcomm.com/i/905854
22 ADVOCATE | WINTER 2017 ESProfessional n 1. Nominee's name __________________________________________________________________________________________ Nominee's Local Association ________________________________________________________________________________ Nominee's address ________________________________________________________________________________________ City _______________________________________ State _________________ ZIP ___________________________________ Home Phone (______) _________________________________ Work Phone (______) _________________________________ Position _________________________________________________________________________________________________ Responses to questions 2-4 may be handwritten or typed and attached to the nomination form. 2. Describe the nominee's contribution to the learning environment of the school or the working conditions for employees beyond the daily routine of activities and job responsibilities. ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ 3. What specific group(s) within the school community are effected by the actions of the nominee? ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ 4. Thoroughly describe the contributions to the local association, support of fellow employees, and/or the student population. ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ ________________________________________________________________________________________________________ List the names, positions and phone numbers of at least two people who are willing to be contacted as references about the nominee. 1. ______________________________________________________________________________________________________ 2. ______________________________________________________________________________________________________ Name of nominee's local association president __________________________________________________________________ This nominee is and has been a member of AEA for three years in good standing. Signature of local president __________________________________________________________________________________ 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