Patty Smith Hill Award

Application Form

Name of Nominee______________________________________________________

Home Address: ________________________________________________________
_____________________________________________________________________

City _________________________ State/Province _______________________

Postal Zone __________________ Country _____________________________

Home Phone Number (Include Country Code) __________________________

Home Fax Number (Include Country Code) ____________________________

Home E-mail Address: _____________________________

Years of ACEI Membership_________________________

Nomination submitted by (Your name)______________________________________________________

Branch, State/Province/Country Association or Educational Institution:

_____________________________________________________________________

Home Phone Number (Include Country Code) __________________________

Home Fax Number (Include Country Code) ____________________________

Home E-mail Address: _____________________________

Please list professional contributions or service to ACEI. If you need more space, please attach an extra page. You must also attach documentation supporting the exemplary contributions:

_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________

Please list examples of work and accomplishments in the field of childhood education. If you need more space, please attach an extra page. You must also attach documentation supporting the exemplary contributions:

Include nominee's curriculum vitae and a substantive letter from the nominating person justifying the nomination. Please return to ACEI Headquarters by February 15.

RETURN THIS COMPLETED FORM AND ACCOMPANYING DOCUMENTS TO

Attn: Patty Smith Hill Award
Association for Childhood Education International
17904 Georgia Avenue, Suite 215
Olney, MD 20832 U.S.A.
Questions? Contact us at:
Tel: 1 (301) 570-2111 ** Fax: 1 (301) 570-2212 ** E-mail: aceihq@aol.com

Return to ACEI home page.