Maryland ASCD Excellence Award

Announcing the Maryland ASCD 2011-2012 Excellence Awards

Recognizing Outstanding Individuals, Teams, and Programs in Education

Nomination Form

Please submit this Nomination Form with a page listing the information requested for the specific award, a narrative summary of no more than three pages specific to the type of nomination as listed below, and three letters of support.

Type of award: (Check one) ___Individual _Team ___Program

Name of outstanding educator
Resume of nominee, including contact information
Summary of personal accomplishments, including specific examples of how the individual has contributed to the development and achievement of educators and students

Title of outstanding Maryland education team
Name of team members and contact information for the person representing the team
Summary of team accomplishments, including specific examples of how the team has contributed to the development and achievement of educators and students

Title of outstanding Maryland educational program
Name and contact information of educator representing the program
Summary of program accomplishments, including specific examples of how the program has contributed to the development and achievement of educators and students

Name of person responsible for completing the Nomination Form:

____________________________________________________

Address______________________________________________

______________________________________________

Phone Number (W)_____________________________________

(H) _____________________________________

Email Address_________________________________________

· Completed nomination application packets must be received by Maryland ASCD by May 13, 2011.

· Awards will be presented at the annual Fall Meeting.

· Submit nominations to Excellence Award Chair, Maryland ASCD, PO Box 703, Westminster, MD 21158.