Society of Health and Physical Education- Michigan - Honor Award for Distinguished Professional Service

* Email

* Name of person making nomination:

* Address of person making nomination

* Name of Nominee:

* Nominee's Home Address:

* Nominee's E-mail:

* Nominee's Phone Number:

* Is the nominee a current member of SHAPE - MI? (examples listed in criteria)

Yes
No

* How has the nominee been actively engaged in allied health and /or physical education disciplines for at least 10 years? (Examples listed in criteria)

* How has the nominee lived and contributed to elevate awareness of healthy, active lifestyles? Has the nominee had activities that inspired youth, young professionals, colleagues and community members in the State of Michigan?

* How has the nominee sustained service to SHAPE-MI and other local, regional and/or national professional organizations such as SHAPE-America, NAHPL, Special Olympics, ACSM, MHSAA or Governor's Council? (Examples listed in the criteria)

* How has the nominee demonstrated leadership and service as a curriculum consultant?

* How has the nominee served as a professional advocate through services rendered?

* List examples of what the nominee has authored or co-authored whether that is books and/or articles or systematic research that has advanced the profession.

* What scholarships, grants or fellowships has the nominee received

* List examples of how the nominee served as a professional role model, mentor or advocate for others in the allied professionals.

* Upload a current picture or headshot of nominee:

* Upload three letters of support for this nomination (the nomination letter can count as one of the letters)

Members Log In
Michigan Association for Health, Physical Education, Recreation & Dance ID:

Password:

	Forgot Username/Password?