*Question 1 asks for information about the person making the nomination*

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* 1. What is your...

*Questions 2-14 ask for information about the nominee*

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* 2. Nominee's contact information:

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* 3. In what BOCES supervisory district is the nominee's board of education located? Use the drop-down menu to make your selection.
[Note: If the nominee is no longer currently on a board of education, use the most recent board that he/she was on to identify the BOCES supervisory district]

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* 4. In what NYSSBA area is the nominee's school district or BOCES located? Use the dropdown menu and map below to answer this question.

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* 5. Does the nominee currently serve on a school district board of education?

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* 6. Does the nominee currently serve on a BOCES board of education?

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* 7. On what date did the nominee first begin board service?

Date

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* 8. On what date does the nominee's current term end?
[If the nominee does not currently serve on a board of education, when did his/her most recent term end?]

Date

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* 9. Please upload a copy of the resolution passed by the board of education endorsing the nominee for this award [Only PDF, DOC, DOCX, PNG, JPG, JPEG, GIF files are supported].

Alternatively, you may copy and paste the resolution in the field below in question 10.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Choose File

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* 10. Place text of resolution here if you did not upload it in question 9:

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* 11. Please list the nominee's relevant board-related activities (e.g., board committees, NYSSBA activities, advocacy activities, etc.). For help with this question, you may contact Patrick Longo, NYSSBA Member Relations Manager, at patrick.longo@nyssba.org or (518) 783-3706.

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* 12. Please list the nominee's relevant board-related accomplishments:

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* 13. Please list the nominee's non-board-related activities and accomplishments (e.g., community boards served on, community service, professional accolades, etc.):

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* 14. Please upload copies of the three mandated letters of recommendation, one of which must be from the superintendent of the school district or BOCES related to the board on which they serve(d):

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
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Please click "DONE" below to submit your nomination form.

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