South Dakota Education Association/NEA
Human and Civil Rights Award
Name of Nominee: ________________________________________________
Member of SDEA/NEA _____yes _____no (if eligible for active membership)
Current Address: ________________________________________________
________________________________________________
Phone: ________________________________________________
Please indicate the reasons for the nomination and the qualifications of the nominee in 100 words or less. You may attach supporting documents to substantiate your nomination. Consideration for the award should include a nominee’s involvement in one or more of the following areas: child abuse prevention, cultural awareness, eliminating racial and gender inequities, drop-out prevention, suicide prevention, strengthening minority education, women’s concerns, disability awareness, or working with the disadvantaged.
Nominator: ________________________________________________
Address: ________________________________________________
________________________________________________
Phone: ________________________________________________
Please mail this form with any attachments to: President, SDEA/NEA, 411 East Capitol, Pierre, South Dakota 57501. Nominations must be postmarked no later than October 1.