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Distinguished Service Award Nomination Form

You are invited to submit a nomination for the Health and Physical Education Council (HPEC) Distinguished Service Award.

The candidate must be a current or former member of the Health and Physical Education Council and shall have performed distinguished, meritorious, and special service as a leader in the field of health and/or physical education.

Letters of reference from two council members must accompany nomination forms. Only nominations accompanied by the appropriate documentation and endorsement will be considered.

The award will be in the form of a plaque in the shape of the province of Alberta with an appropriate inscription. A maximum of two awards are presented each year at the annual conference.

Submission Deadline: January 15 of each calendar year

The selection committee will consider the names and information contained herein confidential. The candidate must be, or have been, a member of the Health and Physical Education Council of the Alberta Teacher’s Association.

For distinguished service to physical education and/or health education in Alberta through leadership as a citizen, I nominate:

Distinguished Service Award Nomination Form


In the event that the committee requires additional information, please include your contact information below. Only Health and Physical Education Council Members may nominate persons for this award.
Nominee First Name*
Nominee Last Name*
Address*

In the event that the committee requires additional information, please include your contact information below. Only Health and Physical Education Council Members may nominate persons for this award.
Endorser First Name*
Endorser Last Name*
Endorser Position*

In the event that the committee requires additional information, please include your contact information below. Only Health and Physical Education Council Members may nominate persons for this award.
Reference 1 First Name*
Reference 1 Last Name*
Reference 1 Position*
Reference 1 Address*
Reference Letter 1 Upload*
Reference 2 First Name*
Reference 2 Last Name*
Reference 2 Position*
Reference Letter 2 Upload*

In the event that the committee requires additional information, please include your contact information below. Only Health and Physical Education Council Members may nominate persons for this award.
Endorsers Email*
Endorsers Phone Number

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