Miss Teen Promise Salute To An Outstanding Teacher Nomination Survey

MTP Life Touchers: "I Want To Nominate An Outstanding Teacher!"

NOMINATION CRITERIA:

Is an Arkansan who is a nice and positive classroom teacher;
A good role model for young females;
Gives from her heart and helps when and wherever she can;
Her achievement(s) prove that she has achieved the Teen Promise 5 Principles of Success of being a positive, poised, professional, productive and polished lady;
May be well known or not known at all by the masses; but, would be a good person for others to know and learn from;
Someone who significantly impacted your life and helped shape you into the successful person you are today or significantly impacted the life of someone you know.
Deserves a $500 Classroom Grant Award.

NOMINATION PROCESS:

1.) List and explain two life touching reasons why the nominee is an outstanding woman and educator.

2.) Briefly explain the achievement(s) that prove the nominee has achieved the Teen Promise 5 Principles of Success: Positive, Poised, Professional, Productive and Polished lady.

3.) Explain why the nominee deserves a $500 Grant for her classroom.

4.) Email a head shot photo of the nominee to info@missteenpromise.com after submitting survey application.

5. Nomination Deadline: 5:00 PM, Wednesday, August 23, 2017. Life Toucher's will be honored during the 20th Annual Miss Teen Promise Scholarship Program Festivities. All proceeds benefit the Miss Teen Promise Scholarship Fund, a nonprofit 501 (c) 3 organization.

Question Title

* 1. What is the name of female teacher nominee?

First Name:

Last Name:

Question Title

* 2. What is the contact information of female nominee?

Mailing Address:

City:

State:

Zip:

County:

Phone Number:

Email Address:

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* 3. Which race/ethnicity best describes the female nominee?

White

Black or African-American

American Indian or Alaskan Native

Asian

Native Hawaiian or other Pacific Islander

Hispanic or Latino

Some other race (please specify)

Question Title

* 4. What is the primary basis for this nomination?

Outstanding Woman

Educator Who Has Touched The Lives of Many

Educator Who Has Touched My Life

New Educator with Great Promise

Classroom Grant of $500 Would Help Tremendously

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* 5. How many years has the nominee served as a classroom teacher?

1-3

4-9

10-20

21- 30

Retired Educator

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* 6. What is the name of the school where female nominee is/was a teacher?

School Name:

Address/City/Zip:

Principal's Name:

Phone Number

Question Title

* 7. List and explain two life touching reasons why the nominee is an outstanding woman and educator. Please include details of how she has achieved the Teen Promise 5 Principles of Success of being a positive, poised, professional, productive and polished lady.

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* 8. Why should Miss Teen Promise Inc. invest in the nominee and her classroom with a $500 Classroom Grant?

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* 9. I certify that my answers are true and complete to the best of my knowledge. I'm proud to submit this "MTP Life Touchers A Salute to an Outstanding Teacher Nomination." To complete the nomination, please email a professional head shot photo of the nominee to info@missteenpromise.com after you click submit. Thank you!

Nominator's Name/Organization:

Nominator's Email Address:

Nominator's Phone Number:

Nominator's Relationship to Nominee: