Providing Leadership to Encourage the Continuing Enhancement of
Teaching, Learning, and Understanding Mathematics

Alberta Mathematics Educator Award Nomination Form

Part 1

Nominee's Name        ________________________________________________
Home Address           ________________________________________________
City and Postal Code ________________________________________________
Business Address       ________________________________________________
City and Postal Code ________________________________________________

Home Phone _______________ School Phone ___________________

Home Email _______________________________________________

School Email ______________________________________________

Signature of Nominee _______________________    Date _______________________

Part 2

Nominator's Name      ________________________________________________
Home Address           ________________________________________________
City and Postal Code ________________________________________________
Business Address       ________________________________________________
City and Postal Code ________________________________________________
MCATA Membership No. ___________________    Member Since ___________

Home Phone _______________ School Phone ___________________

Home Email _______________________________________________

School Email ______________________________________________

Signature of Nominator ______________________    Date_____________________________

Part 3

A minimum of three letters of support.  Send or Email completed nomination application to current Director of Grants and Awards
Deadline for receipt of applications:  August 1 of each year