Golden Apple Award Teacher Nomination Form
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Indicates a required field.
Teacher's Name:
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Teacher's School:
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Teacher's Grade/Subject:
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Nominator's Name:
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Nominator's Street Address:
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Nominator's City/State/Zip:
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Describe the positive impact this teacher had on the life of a specific student:
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Relationship of nominator to teacher:
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Student
Former Student
Parent of Student
Teacher/Staff
Administrator
Other
