NSELA - Awards

Outstanding Leadership in Science Education Award
Nomination Form

All nomination materials are due by December 1
Both the nominee and person placing the nomination must be current NSELA members.

Please read the award description before submitting a nomination.

Nominee Information
Name
Position/Title
Work Phone
Work Address
Home Address
Home Phone
Email
Nominator Information
Name
Position/Title
Work Phone
Work Address
Home Address
Home Phone
Email

Candidate’s education record. Include college, attendance dates, degree, and field of study. Also include institutes and special programs.
List professional organizations of which the candidate is a member. Any special position held or any special contribution to any organization should be mentioned with dates for office held or contribution made.
List any special awards or professional recognition the candidate has received.
List publications the candidate has written (if any) or presentations the candidate has given. For each, give the title and a brief description.
Briefly describe the type of supervisory or science leadership capacity in which the nominee is presently engaged. Give the title and responsibilities for the position.
Briefly describe any prior supervisory or science leadership experiences.
Describe in 500 words or less, the exemplary nature of the nominee’s contribution to science education. Include in your description specific contributions the nominee has made to improve a science program and student learning.
Name of District Superintendent or Supervisor
Superviosr's Address
Supervisor's Email
Name of Local Newspaper
Address of Local Newspaper
Support Letters From: Please include letters of support (no less than 3, or more than 5), from the following: (a) superintendent or immediate supervisor, (b) a subordinate, (c) other as appropriate. Be sure to email the following and have them complete the Support Letter Form
1. Name
Work Phone
Work Address
Email
2. Name
Work Phone
Work Address
Email
3. Name
Work Phone
Work Address
Email
4. Name
Work Phone
Work Address
Email
5. Name
Work Phone
Work Address
Email
Before you click Submit read this! When this form is submitted, you will automatically receive an email copy of the information (if you enter your email address correctly). Please forward this email to the names listed above as providing support letters. Inform them that they must complete the Support Letter Form by the deadline in order for the nominee to be considered for an award. Thank you for your nomination.
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