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Elizabeth Green School Educator Award   Nominee Nominee_______________________________________________________________ Title_______________________________________   Address________________________________________________________________  City____________________________________State___________________________   Phone______________________________E-mail_______________________________   Current Position__________________________________________________________ Yrs in Position_______________Yrs in Profession________________ The selection committee's initial assessment of the nominee will be based upon a narrative provided by the nominator. The narrative should be limited to one page and must address all of the following: the nominee's impact on students; the nominee's impact on the musical development in his/her school, community, and state; and the nominee's pursuit of his/her own professional development. Narrative may also provide other information such as past teaching awards, leadership activities,etc. Nominator Nominator______________________________________________________ Title______________________________________   Address_________________________________________________________ City_________________________________State_______________________   Phone__________________________E-mail______________________________ References The selection committee will narrow the applicant pool (using the narrative provided by the nominator). Upon arriving at the semi-final list, the committee will contact three references who will need to be able to speak of the abilities of the nominee. These references must be an administrator, a teacher/colleague, and a student or parent. Administrator Administrator Name______________________________________________________ Title__________________________________________________________________   Address________________________________________________________________ City______________________________________State__________________________   Phone________________________________E-mail______________________________   Colleague Colleague Name____________________________________________________________ Title______________________________________________________________________   Address___________________________________________________________________ City______________________________________State_____________________________   Phone________________________________E-mail________________________________   Student or Parent Name______________________________________________________________________ Address____________________________________________________________________ City_________________________________________State___________________________   Phone__________________________________E-mail_______________________________   ASTA with NSOA State President I certify that the nominee on this form is employed in the above described activities. President's Name_________________________________________________________ President's Signature______________________________________________________ Address_________________________________________________________________ City______________________________________State__________________________ Phone_________________________________E-mail____________________________     ©2005 ASTA with NSOA, Nebraska Unit, C. Ellenwood, Webmaster