MTS Honourary Membership Award Form

Nominator

Nominator Name *

First

Last

Nominator MTS Number

Nominator Local Association

Nominator Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Nominator Primary Telephone *

Nominator Email *

Declaration of Nominator. I confirm that: *

I have carefully read the eligibility criteria and nomination guidelines for this award.
I am an eligible nominator as described in the nomination guidelines.
The nominee meets the eligibility criteria.
I agree to keep the results confidential until the nominee is notified.
I am unaware of any circumstances that would preclude this nominee from qualifying for this award.
The statements in my nomination are complete and accurate, to the best of my knowledge.

Date *

NOMINEE

Nominee Name *

First

Last

Nominee MTS Number

Nominee Local Association

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Nominee Primary Telephone *

Nominee Primary Email *

Declaration of Nominee. I confirm that: *

I have carefully read the eligibility criteria and nomination guidelines for this award.
I am an eligible nominee as described in the nomination guidelines.
I agree to keep the results confidential until it is public.
If I am the successful recipient, I will provide the Society with photos and bios as requested.
If I am the successful recipient, I will attend the Annual General Meeting of Provincial Council in May 2023 to accept my award (expenses paid).
The statements in this nomination are complete and accurate, to the best of my knowledge.

Date *

1. Describe how your nominee has promoted and advanced the cause of public education in Manitoba? Please provide 3-5 specific examples. *

1200 word count max.

2. Describe how your nominee has advanced and safeguarded the welfare of teachers in Manitoba? Please provide 3-5 specific examples. *

1200 word count max.

3. Describe how your nominee has advanced and safeguarded the teaching profession in Manitoba? Please provide 3-5 specific examples. *

1200 word count max.

4. Is there any other information you’d like to share in support of your nomination? *

1200 word count max.

5. Is your nominee retired? *

Yes
No

If not, why should this honour be conferred now? *

LETTERS OF RECOMMENDATION (3 max.)

You may submit up to three letters of recommendation from other members in support of your nomination. These may be Word documents of up to 500 words each, accompanying your nomination form.

File Upload

Submitted by: (Teachers' Association) *

Per: (President) *

MTS Honourary Membership Award Form

Nominator

NOMINEE

LETTERS OF RECOMMENDATION (3 max.)

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