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Instructions
For most answers, check the box or boxes most applicable or fill in the blanks.
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Please provide data about yourself (*required)
First Name*
Last Name*
Address*
City*
State / Province*
Zip Code*
Phone (day)*
Phone (evening)
Email
Award Categories
1.
What is the award category for this nominee?
Schools of Excellence/School District
Thad Cochran Distinguished Arts Educator
Outstanding Administrator of the Year
Excellence in Higher Education Award
Exemplary Arts Service Award
Distinguished Community Arts Agency or Cultural Institution Program Award
Lifetime Achievement Award
2.
If your choice is the Thad Cochran Distinguished Arts Educator award, please specify the appropriate discipline.
Dance
Music
Theatre
Visual Art
Arts Integration
Nominee Information
3.
Name of Nominee:
4.
Address:
5.
City:
6.
State:
7.
Zip:
8.
E-mail:
9.
Phone (day):
10.
Phone (evening):
11.
Fax:
12.
Current MAAE member?
Yes
No
13.
Nominee's position or title:
14.
Total teaching/administrative experience: (Number of years--all positions)
15.
Total number of years at current position:
16.
Supervisor's Name:
17.
Superintendent's Name:
If nominee is a school, district, institution, or agency, please supply the following information:
18.
Name of school, district, institution, or agency:
19.
20.
21.
22.
23.
Phone:
24.
25.
Professional arts and community organizations
26.
Please list professional arts and community organizations in which the individual nominee is an active member. Indicate offices and responsibilities held in these organizations.
27.
In what capacity do you know the nominee?
Awards Nomination Narrative
Please read and respond to the following questions. Base answers on ways the nominee meets the stated criteria for the award. Limit your response to 500 words or less for each question.
28.
PRACTICE: Briefly describe events or experiences from the past five years that illustrate how the nominee is directly involved in arts education. (20 points)
29.
PERFORMANCE: What qualities distinguish the nominee from others who do similar work? (30 points)
30.
ACHIEVEMENT: In what ways has the nominee been recognized for excellence or leadership in arts education? (25 points)
31.
COMMITMENT: How does the nominee promote the benefits of arts education that this award celebrates? (25 points)
The following question is a precaution to ensure that the person responding hasn't inadvertently attempted to "submit" the survey prematurely by using the "enter" key instead of "tab" or mouse click between questions.
32.
Are you ready to submit this form? If so, check "Yes", then click the "Submit" button below.
Thank you for your participation in the nomination process. Please consider becoming a member of the Mississippi Alliance for Arts Education so that you may add your voice to members across the state who seek to increase access to arts education for all Mississippi students.
Surprising Solutions: Arts Education
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