Nomination Form – North Carolina Music Educators Association

Name of candidate*
Prefix First Last Suffix
Statement of nomination:*
Create a statement which encapsulates the qualities you feel support your nomination of this candidate and which would be appropriate for reading at the award ceremony as a summary of their achievements.
Educational Background/Collegiate Awards*
List these
Post graduate study/Degrees/ Awards*
List these
Teaching history in NC*
List these
Awards received*
List these teaching awards
Elected and/or appointed leadership positions*
teaching/music related within our state
State Contest/All-State/ Honors Chorus/ Summer Program participation*
List ALL these if number of superior ratings are known, list the number and/or list years of participation in each category.
MENC/ADCA Offices/Performances*

refers to National level leadership/performances, List these
NC-MEA/NC-ACDA Offices/Performances*

refers to State leadership/performances, List these
Other professional organizations/affiliations*

Can be nonmusical or musical, List these
Church/Community Leadership*

List these, nonmusical and musical , if not already noted
School/Church/Community Awards and Recognition's*
List these, not already noted
Nominee Phone*
Nominee Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Nominee Email*
Contact for Relatives*

Sponsor Information
Due to the extraordinary nature of this Award three sponsors are required and may complete the form as a committee. Care should be taken to assure all information provided on the nominee is listed chronologically and is absolutely accurate.
Primary Sponsor
Name*
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Enter Email Confirm Email
Secondary Sponsor
Name*
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Enter Email Confirm Email
Third Sponsor
Name*
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Enter Email Confirm Email
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Performance Submission