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Ethnic Minority Recognition Award Nomination Form
Please enable JavaScript in your browser to complete this form.
MSEA Ethnic Minority Recognition Award Policy and Guidance
Before beginning work on your nomination form, please take a moment to review MSEA’s Ethnic Minority Recognition Award Policy and Guidance document. It will assist you in assuring that your nominee meets the award criteria and that your nomination form is submitted properly. It can be found by clicking
HERE.
DEADLINE: 11:59pm on November 1 of the prior year in which the award is to be given. Late or incomplete nomination forms will NOT be considered.
Please complete this form to nominate a candidate for the MSEA Ethnic Minority Recognition Award.
In order to be considered complete, this submission form must also include the nomination forms from your four (4) secondary nominators and the award nominee acknowledgement form.
The secondary nominator form can be found by clicking
HERE.
The award nominee acknowledgement form can be found by clicking
HERE.
Note: Only current MSEA members are eligible to nominate a candidate. Nominators are required to provide their MSEA Member number.
After collecting the four (4) completed secondary nominators’ forms, please upload the forms in the space provided at the bottom of this nomination form. Similarly, please upload the nominee acknowledgement form in the space provided below the secondary nominators form.
The MSEA Minority Affairs Committee will review submitted nomination forms and will make recommendations to the MSEA Board of Directors for final approval.
Please be sure to complete all required fields of the nomination form.
If you have questions, email
[email protected]
with “Minority Recognition Award Question” in the subject line.
Award Sought
*
–SELECT ONE–
Community
Education
Leadership
Politics
Student
Name of Nominee
*
First
Last
Nominee's Local Affiliate
*
–Select One–
ACEA
AFSCME
APSASAC
APSASCCO
CAESS
CaroCEA
CarrCEA
CASE
CCCTA
CEA
CESPA
DASA
DE
EACC
EASMC
ESPBC
FASSE
FCASA
FCTA
GASA
GCEA
HaCEA
HoCEA
KCESPA
KCTA
MCEA
PGCEA
QACEA
SAAAAC
SEA
SMASA
TAAAC
TABCO
TCEA
WasCESP
WasCTA
WCEA
WCESPA
WorCTA
Name of Primary Nominator
*
First
Last
MSEA ID #
If you do not know your MSEA member number, email
[email protected]
with “MSEA Member Number” in the subject line.
Primary Nominator's Address
*
Address Line 1
Address Line 2
City
— Select state —
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Primary Nominator's Contact Number
*
Primary Nominator's Personal Email
*
Primary Nominator's Local Affiliate
*
–Select One–
ACEA
AFSCME
APSASAC
APSASCCO
CAESS
CaroCEA
CarrCEA
CASE
CCCTA
CEA
CESPA
DASA
DE
EACC
EASMC
ESPBC
FASSE
FCASA
FCTA
GASA
GCEA
HaCEA
HoCEA
KCESPA
KCTA
MCEA
PGCEA
QACEA
SAAAAC
SEA
SMASA
TAAAC
TABCO
TCEA
WasCESP
WasCTA
WCEA
WCESPA
WorCTA
Which of the following award criteria have been met by the nominee? Select all that apply.
*
Demonstrates devotion, resilience, and strength in organizing traditionally disadvantaged workers.
Organizes with racially/ethnically diverse groups to support and empower disadvantaged workers and their families.
Helps to improve intergroup relations and understanding among racial and ethnic groups.
Works beyond the call of duty to free the education profession from inequities based on race, ethnicity, gender, or sexual orientation.
Secures community recognition for their contributions to intergroup relations.
Displays creativity, determination, and perseverance in achieving human and civil rights goals.
Established an ongoing program or institution for the improvement of human relations and civil rights.
Initiated or engages in activities that positively impact the educational, social, economic, or political life of the community.
Promotes public policy that positively affects the economic health and welfare of families.
Works actively to improve economic opportunities for all people.
Inspires direct action in the cause of human and civil rights.
Helps schools develop programs that enhance the education of LGBTQIA students and teaches other students to refrain from activities such as bullying, stereotyping, and fighting.
Promotes appreciation for diversity with regards to sexual orientation.
Describe specific examples of: actions taken by the nominee that promote and defend human and civil rights, activities promoting human and civil rights undertaken by the nominee that have a community-wide impact, ways in which the nominee has demonstrated leadership in the areas of human and civil rights activism, and/or the exceptional contributions the nominee has made/is making to education in Maryland in the area of human and civil rights.
*
Minimum: 100 words; Maximum: 250 words.
I have read and understand MSEA’s Ethnic Minority Recognition Award Policy.
As the primary nominator for this award, I understand that I am responsible for collecting and submitting all required elements for this nomination form, including supporting materials and secondary nominator forms (4 total, including nominators’ signatures), and that my failure to do so will result in my incomplete nomination form being rejected by MSEA’s Minority Affairs Committee.
I certify that I am a current member of MSEA.
Primary Nominator's Signature
*
Clear Signature
Upload the four (4) required secondary nominator forms here.
*
Click or drag files to this area to upload.
You can upload up to 4 files.
Upload award nominee acknowledgement form HERE.
*
Click or drag a file to this area to upload.
Upload brief biographical sketch of nominee HERE.
*
Click or drag a file to this area to upload.
Upload nomination supporting materials
Click or drag a file to this area to upload.
Upload nomination supporting materials
Click or drag a file to this area to upload.
Upload nomination supporting materials
Click or drag a file to this area to upload.
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