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Guidelines
Application
Reference Form
Written Statement
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Student Leadership Awards were established to help deserving students have additional opportunities for personal and professional growth. They are intended to honor both those who have made outstanding contributions to the development and extension of ACEI, as well as those who have made contributions to the advancement of children's education.
A student is defined as an undergraduate/graduate student, full-time during the academic year. A student may self-nominate or may be nominated by a Branch.
ACEI will:
ACEI Membership # _________________________ How long an ACEI Member? _______________
Branch Affiliation ______________________________________________________
Mailing Address: ________________________________________________________
_____________________________________________________________________
Permanent Mailing Address (if different from the mailing address listed above)
________________________________________________________
_____________________________________________________________________
Home Phone Number (Include Country Code) __________________________
Work Phone Number (Include Country Code) ____________________________
E-mail Address: _____________________________
Name of college/university ______________________________________________________
Name of college advisor ______________________________________________________
Advisor's school address ______________________________________________________
______________________________________________________
Check one: _____ full-time student _____ part-time student
College major _________________________ Expected date of graduation _____________
Degree being earned ______________________________________________________
High School activities ______________________________________________________
College activities ______________________________________________________
Honors/Scholarships received ______________________________________________________
Community activities ______________________________________________________
ACEI activities ______________________________________________________
List the name of three references:
______________________________________________________
______________________________________________________
______________________________________________________
Attn: E.B. Student Leadership Award
Association for Childhood Education International
17904 Georgia Avenue, Suite 215
Olney, MD 20832 U.S.A.
Tel: 1 (301) 570-2111 ** Fax: 1 (301) 570-2212 ** E-mail: aceihq@aol.com
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Name of student __________________________________________________________
NOTE: If you are completing a reference form for more than one student, you can be most supportive by writing individualized comments for each applicant.
1. How long have you known the applicant, and in what capacity? __________________ _____________________________________________________________________
2. What is your evaluation of the applicant's academic ability? _____________________ _____________________________________________________________________ _____________________________________________________________________
3. Are there any economic or unique factors that make the applicant especially worthy of receiving scholarship support? ____________________________________________ _____________________________________________________________________ _____________________________________________________________________
4. Additional comments ___________________________________________________ _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________
Signed _________________________________________ Date _________________
Job Title ________________________________________
Mailing address __________________________________________________________ __________________________________________________________
Attn: E.B. Student Leadership Award
Association for Childhood Education International
17904 Georgia Avenue, Suite 215
Olney, MD 20832 USA
Tel: 1 (301) 570-2111 ** Fax: 1 (301) 570-2212 ** E-mail: aceihq@aol.com
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Using the space below and additional page, if needed, explain why you choose
membership with ACEI, why you are applying for the Elizabeth Breathwaite Student
Leadership Award, and why you are interested in teaching/professional education/child-related
field as a career. Please limit your answer to 500 words or less; submissions
should be printed or typed.
________________________________________________________________________
________________________________________________________________________ ________________________________________________________________________
________________________________________________________________________ ________________________________________________________________________
________________________________________________________________________ ________________________________________________________________________
________________________________________________________________________ ________________________________________________________________________
________________________________________________________________________ ________________________________________________________________________
________________________________________________________________________ ________________________________________________________________________
________________________________________________________________________ ________________________________________________________________________
Student signature _________________________________________________________
Faculty Advisor signature __________________________________________________
Checklist: Please make sure you have included the following items with
this application:
1. Completed student Application form
2. Three completed Reference Forms
3. Completed Written Statement
4. A nonreturnable black and white picture (preferably)
Attn: E.B. Student Leadership Award
Association for Childhood Education International
17904 Georgia Avenue, Suite 215
Olney, MD 20832 USA
Tel: 1 (301) 570-2111 ** Fax: 1 (301) 570-2212 ** E-mail: aceihq@aol.com
These pages are copyright
1996-2004
by the Association for Childhood Education International. Please send any comments
to Marilyn Gardner at aceimemb@aol.com.