SCSIA: Teaching (Application Form) Application Form: SCSIA: Teaching Application Form The Schubert Club Social Impact Award Category: Teaching IMPORTANT INFORMATION: PLEASE READ BEFORE BEGINNING YOUR APPLICATION • All nominators must be 18 years of age or older. • Nominators may nominate only one person per Schubert Club Social Impact Award category. • The same nominee may be nominated for all three Schubert Club Social Impact Award categories. • One may nominate oneself. • Nominations may be obtained from any member of the nominee's community provided that they are individuals who are 18 years of age or older. FREE RESPONSE QUESTIONS: •You may answer one, a couple, or all of the free response questions below. •Weight will be given to well written responses with greater detail. PART A: NOMINATOR AND NOMINEE INFORMATION 1. Nominator Name i.e. The individual completing this form * 1. Nominator Name i.e. The individual completing this form First Name First Name Last Name Last Name 2. Nominator Email * 3. Nominee Name i.e. The individual being elected to receive the award * 3. Nominee Name i.e. The individual being elected to receive the award First Name First Name Last Name Last Name 4. What is your relationship to the Nominee? If you are nominating yourself, state "SELF" * 5. How long have you known the Nominee for? * Less than 1 year 1-2 years 3-4 years 5+ years I am the Nominee PART B: SHORT RESPONSE QUESTIONS 1. Please provide examples of how the Nominee has shown a commitment to music education. (Maximum 100 words) 2. Please provide examples of how the Nominee has had a positive influence on their students' progression in music (Maximum 100 words) 3. Please provide examples of how the Nominee has shown a personal commitment to being a lifelong learner and has continued to develop and hone their craft in teaching. (Maximum 100 words) SUBMIT If you are human, leave this field blank. Please leave this field emptySign Up To Our Newsletter Enter your name and email address to receive regular updates and news about our upcoming events! Thank you! Please check your inbox or spam folder to confirm your subscription.
