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National Association for Alternative Certification
2016 Award Recognizing Outstanding New Educators
Prepared through Non-traditional Teacher Preparation Programs
Nomination Form
Name of NAAC member endorsing or submitting this nomination:
Alternative Certification/Licensure Program:
Name of intern/teacher/resident being nominated:
Job Title/Teaching Position:
School:
School Address:
City:
State:
Zip:
Home address:
City:
State:
Zip:
Email (required):
Daytime Telephone:
Home Telephone:
The nominee qualifies to apply for this scholarship because:
o
S/he is currently an intern/teacher candidate in an alternative certification/licensure program, or
o
S/he completed an alternative certification program within the last year.
Date of Completion: _________________________
In addition, it is acknowledged that the scholarship will be awarded during the March 6-9, 2016 NAAC annual conference
in New Orleans and winners must be in attendance to receive the award.
Signed: ___________________________________________ Date: ________________________