Patricia Gilcrest-Frazier Award Nomination Form

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This award recognizes outstanding service and leadership by a special education administrator in a LOCAL SCHOOL DISTRICT OR PUBLIC SCHOOL ACADEMY. Nominees must be members of MAASE, employed by a local district or PSA, and exhibit the qualities outlined in the form below. The Award will be presented at the June 2020 General Membership Meeting.

Complete the nomination form below by MAY 1, 2019. The Awards Committee will review all nominations. If your colleague is selected to move further through the process, they will reach out to the three colleagues you provide on this nomination form for additional supporting information.

Name of Nominee *

Nominee's Current Title *

Nominee is a member of MAASE *

Yes

Examples of Service *

Examples of Leadership (Outstanding contributions, staff recognition, program development, etc.) *

Examples of Vision (Brings future into focus, innovator, systems orientation) *

Examples of Collaboration (Works effectively with others, organizations, promotes others) *

Lifelong Learning (Evidence of continuing development) *

Additional qualities that distinguish him/her as worthy of this award *

Provide the names and email addresses of three (3) additional colleagues who can provide supporting letters in the event your nominee is moved forward in the selection process. *

Person Submitting Nomination *

Nominator's Ofﬁce Phone *

Nominator's Home Phone *

Nominator's Email *

Submit

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