This form is to be completed by the nominee for the award.× "*" indicates required fields Type of Nomination*What used to be a unified Speech, Debate, and Theatre educator award has been split into two areas, so even if an educator does speech/debate AND theatre, please select one of the two areas. This application should be completed with an emphasis on the type selected. Speech and Debate Theatre NomineeNominee's Name* Mr.Ms.Mx.Mrs.MissDr.Prof.Rev. Prefix First Last Suffix Nominee's School*Include city of school, if not in school name. Nominee's Home Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Nominee's Work Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Nominee's Home Phone*Nominee's Work Phone*Nominee's Email* Approximate number of years advising this activity*Please enter a number from 1 to 70.Nominee's Photo Drop files here or Select files Accepted file types: jpg, gif, png, tif, tiff, jpeg, Max. file size: 128 MB, Max. files: 3. MementoAdditional fee may apply for mementos.Memento*Please select a memento preference (additional fee may apply). Pendant Ring Ring Gender* Female Male Ring Size*Award ApplicationCareer description as an educator*Career description as a Speech/Debate or Theatre Educator. (Give background and information pertaining to professional involvement in speech/debate or theatre activities, teaching positions, tenure, years of service – both curricular and co-curricular, and personal and professional achievements.) Limit: 200 words.Personal honors and awards*List the nominee's personal honors and awards, (excluding students' achievements). Limit: 200 words.Student honors and awards/achievements*List students' achievements under the nominee's direction. Limit: 200 words.Professional affiliations and service*Include up to 12 state, regional, and/or national organizations -- offices held, committee service, etc. Click the plus sign (+) to the right of the row to add additional entries. OrganizationServiceTenure Add RemoveNominatorPlease include information about your nominator. Once you complete this application, a copy will be sent to the nominator.Nominator's Name* First Last Nominator's Email* NameThis field is for validation purposes and should be left unchanged.
