Outstanding Educational Program

This form is only used to nominate a program for the Outstanding Educational Program of the Year Award.

NOMINEE INFORMATION

Program Name:

Contact Person:

Title:

Institution:

Address:

Address 2:

City:

State:

Zip Code:

Country:

Phone:

Fax:

E-mail:

NOMINATED BY

Name of Nominator:

Title:

Organization:

Address:

Address 2:

City:

State:

Zip Code:

Country:

Phone:

Fax:

E-mail:

SUPPORTING DOCUMENTS

The following supporting documents are required. You may attach them to this form by browsing to the file location on your computer, selecting the document and choosing "save." You may also e-mail the documents to: mailto:awards@aptrweb.org if you have problems using this form. Be sure to include the nominated individual's name in the subject.

Description of program or activity:

Statement of Evidence (letter of support justifying nomination):

ADDITIONAL DOCUMENTS

Any information that supports your reason for nomination is encouraged. This may include: career highlights, University service, honors and awards, publications, and community service. The total additional supporting documents should not exceed 10 pages in length (including appendices).

1. Additional Documents

2. Additional Documents

3. Additional Documents

4. Additional Documents

5. Additional Documents

THANK YOU FOR YOUR NOMINATION

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