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GT AWARD NOMINATIONS FORM

NOMINATION FORM FOR GT SERVICE AND ADVOCACY AWARD 2017

 

Nominee’s Name: (Dr.   Mr.   Mrs.  Ms.) _____________________________________________________________

Home Address: ______________________________________ City/State/Zip ______________________________

Home Phone: __________________________________Work Phone: _____________________________________

Email Address: _________________________________________________________________________________

Years of experience with gifted: _______________________ in what capacity? _____________________________

Nominated by: (Dr.   Mr.   Mrs.   Ms.) _______________________________________________________________

Home Address: ________________________________________ City/State/Zip ____________________________

Home Phone: ____________________________________Work Phone: ___________________________________

Relationship to the nominee: _____________________________________________________________________

Please answer the following questions in detail. Describe accomplishments and information concerning why the nominee should be considered for this award. Additional pages may be used.

  1. What specific contributions has the nominee made toward gifted students, parents, and/or educators of gifted students within the nominee’s everyday classroom and/or school setting?

 

 

  1. Describe the impact of these contributions.

 

 

  1. Explain the extent of advocacy for gifted services within the nominee’s everyday classroom and/or school setting.

 

Please return completed application by March 1, 2017, to:
Supt. Marion Sowders
1922 North US 127
Liberty, KY 42539

              phone: 606.787.6941, email: marion.sowders@casey.kyschools.us, fax: 606.787.5231





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