2023 Award Recipient Information

Congratulations! Please fill out the information below, review for accuracy, and submit by April 15, 2023. This information will be used in the publicity for the event. If it is not received by the deadline, you will unfortunately not be included in the Union Leader. If you have any questions, please reach out to Amie Pariseau at info.nh.edies@gmail.com or 603.228.9585.

Name of Award Recipient *

First

Last

School Address *

Address Line 1

Address Line 2

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

School Phone *

Social Media Handles *

Please share your school’s Facebook, Instagram, LinkedIn, and Twitter handles.

Home Address *

Address Line 1

Address Line 2

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Personal Email *

A current resume or professional history *

Click or drag a file to this area to upload.

A description of your current work to include: 1. What makes your work unique? 2. What impact has your work had on students, staff, parents and/or the community? 3. What impact has receiving this award made on you as a person and as a professional? *

Click or drag a file to this area to upload.

Headshot *

Click or drag a file to this area to upload.

Submit