District Service Award - Retire Nomination Form

NORTHWESTERN OHIO EDUCATION ASSOCIATION DISTRICT SERVICE AWARD RETIRED NOMINATION FORM

This nomination form must be submitted to the NWOEA Center by January 11, 2024.  any questions can be emailed to nwoea.center@gmail.com 

The NWOEA Awards Committee will select award recipients from nominations submitted.  After February 1, 2024, recipients will be notified and invited in writing to be recognized at the NWOEA Awards Reception.

Please fill out the form completely.  Incomplete forms will not be considered.  Only this format will be accepted. This is a NOMINATION.  It does not guarantee the person will receive an award.


Guidelines: District Service Award- Retired Guidelines

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Email *
Name of Nominee *
Nominee's Phonetic Spelling of Name *
Nominee's Local Association (no abbreviations) *
Nominee's Position in Local Association
*
Nominee’s Teaching/Support Assignment
 *
Nominee's Place of Employment
 *

Nominee's Complete Home Address with City, State, and Zip Code *

References – Reference #1

     NAME, OCCUPATION, ADDRESS, and TELEPHONE

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References – Reference #2

       NAME, OCCUPATION, ADDRESS, and TELEPHONE

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References – Reference #3

     NAME, OCCUPATION, ADDRESS, and TELEPHONE

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Name of Person making the Nomination *
Nominator's Local Association (no abbreviations) *
Nominator's Position in Local Association *
Nominator's Complete Home Address with City, State, and Zip Code *
Nominator's email address *
Nominator's phone number *

Give the name and address or online link to submit information of one local newspaper that NWOEA may notify for publication of award information.

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I give my permission as nominator that NWOEA may contact the nominee for additional information if needed.
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Explain in one or two sentences what this nominee has done for your district to prompt you to nominate him/her for this award.

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Please provide information on how the nominee meets the criteria for the award.  List ONLY SERVICE TO THE NWOEA DISTRICT SINCE RETIREMENT.  Be specific. (District Committees, NWOEA Board of Directors, NWOEA Representative to OEA Committees/ Commissions and NEA committees)

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List the Nominee’s community activities, organizations, and honors.  Be specific!


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Please provide additional detailed information you feel has not been covered in the previous sections of this application form, including service at all levels of the Association before retirement.

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Online SIGNATURE of NOMINATOR

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