NOMINATION FORM
Check appropriate box
Rising Star Award
The OCSS member I
wish to nominate is:
Name________________________________________________________________________
School
Affiliation______________________________________________________________
School Address_______________________________________________________________
City/State/Zip________________________________________________________________
School
Phone_________________________________________________________________
Award for which nominee is
to be considered: (circle one)
Elementary Middle/Junior
High Secondary
Title/Subjects
Taught_________________________________________________________
Home Address________________________________________________________________
City/State/Zip________________________________________________________________
Home Phone__________________________________________________________________
E-mail________________________________________________________________________
Nominator:
Name________________________________________________________________________
Title__________________________________________________________________________
Work Address_________________________________________________________________
City/State/Zip________________________________________________________________
Home Phone__________________________________________________________________
E-mail________________________________________________________________________
As the
nominator, I have prepared a nomination packet that includes the nominee’s
vita/professional resume; a narrative of the nominee’s accomplishments (not
more than two pages); and optional supporting documentation.
Signature of Nominator______________________________________ Date
Prepared__________