GEETF Awards Nomination Form - "Dedication to Education" Awards

1.Please provide the name, jobsite and position of the person filling out this form.(Required.)
2.Please provide a phone number tht the Awards Committee could use to contact you outside of school hours if we need any further information about this nomination. (Required.)
3.Is this nomination of a peer, or a self-nomination?
Only one selection.(Required.)
4.Please provide the seconder's name, jobsite and position.(Required.)
5.Name(s), jobsite(s) and position(s) of nominee(s) - Please note: if this was a group project, please nominate the leaders or top contributors to the project or activity.(Required.)
6.Please select the award(s) for which the nomination may be considered.
Check all that apply.(Required.)
7.What is the name of the project for which you would like to nominate the nominee(s)?
8.Give a very short description of the project. Please mention the goals or outcomes of the activity and explain the reasons that you decided to seek an award for the nominee(s). *Point-form is great.*
9.What is the timeline of this project or activity?
10.Approximately how many educators were impacted by this project? Also, which bargaining groups did they represent? (You can select more than one option.)
Check all that apply. (Required.)
11.How many students were impacted by this project? (You can choose more than one answer.)
Check all that apply. (Required.)
12.Did this activity or project have an impact on the community outside of the school?
Only one selection.(Required.)
13.Did this activity have an impact on more than one region (i.e. Haldimand and Norfolk)?
Only one selection.
14.Is there anything else you would like us to know about the impact of this project?(Required.)