Bernice Baumgartner Memorial Award Nomination Form

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This award was established by the PACEC Executive Board to recognize an individual who has made significant contributions to the education of children and youth with exceptionalities, disabilities, and/or gifts and talents.

Candidate Requirements:
●The nominee should have a professional reputation in Pennsylvania and demonstrated exemplary performance over their educational careers to the education of children and youth with exceptionalities.
●These contributions could include one or more of the following areas: publications; research; development of new programs, approaches, concepts; improved psychological or educational evaluation procedures; improved administration procedures; practical application of improved teaching techniques; and dynamic leadership.
●The work of the nominee should be consistent with PACEC and CEC’s mission statement.
●The nominee may be in service or retired and candidates include teachers, administrators, college/university professors, or any other educator that meets the criteria.
●Must be a CEC member in good standing both currently and for at least the previous five years.

Please complete the following application by September 15, 2020 for consideration! Any questions contact pacecmembership@gmail.com

Name of Nominee: *

Nominee's adress:

Nominee's phone number:

Nominee's Email: *

Verification of five years of CEC membership (obtainable from CEC Headquarters): *

Yes, the nominee has been a member of CEC for the previous 5 years

No, the nominee has not been a member of CEC for the previous 5 years

Required

Name of nominator: *

Nominator's CEC membership number *

Nominator's address: *

Nominator's phone number: *

Nominator's E-mail Address *

Description of the outstanding professional contributions of the nominee in the delivery of direct services. *

Recommendation #1 highlighting the nominee's lifetime accomplishments: (include Recommender's name and contact information) *

Recommendation #2 highlighting the nominee's lifetime accomplishments: (include Recommender's name and contact information) *

Vita highlight of Nominee *

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