Dr. Ruth E. Everett Award Application - New York State English Council

Dr. Ruth E. Everett Award

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Name*

First Last

Position*

Level

Elementary

Middle

Secondary

Name of School Where Nominee Teaches:*

Nominee’s School Address:*

Street Address Address Line 2 City State ZIP Code

School Phone:*

School Email*

Nominee’s Home Address:

Street Address Address Line 2 City State ZIP Code

Name of Person Nominating This Candidate:*

First Last

I Nominate This Candidate Because:*

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Phone of Person Nominating This Candidate*

Email of Person Nominating This Candidate*

Address Person Nominating This Candidate*

Street Address Address Line 2 City State ZIP Code