2006 AMC 12 SCHOOL TEAM NOMINATION FORM

For the

EDYTH MAY SLIFFE AWARD
The 2006 AMC 12 team from (Please PRINT):
School :
CEEB:
 Address:
City: State: Zip: -

having placed in the top 60 schools of those participating in the 2006 American Mathematics Competitions 12, would like to nominate the following teacher for this award:  (Only one name may be submitted from each participating school.  The Mathematics Teacher must be currently employed by the participating school from which the student Nomination is submitted.)

Title First Last

The rationale for this nomination is as follows:

Nomination submitted by the following 2006 AMC 12 Team Members:


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Signature
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Signature
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Signature
First Name Last Name
First Name Last Name
First Name Last Name

Email
Email
Email
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Month/Day/Year
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Month/Day/Year
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Month/Day/Year

Please complete this form by April 20, 2006, and

  1. Print off the completed form, having each of the Team member sign it, and send the nomination in the included stamped envelope.  If there are more than three team members, please add the additional signature lines on the back, and, 
  2. Submit it electronically with the submit button,
    Thank You.

_______________________
Signature
_______________________
Signature
_______________________
Signature
First Name Last Name
First Name Last Name
First Name Last Name

Email
Email
Email
//
Month/Day/Year
//
Month/Day/Year
//
Month/Day/Year


_______________________
Signature
_______________________
Signature
_______________________
Signature
First Name Last Name
First Name Last Name
First Name Last Name

Email
Email
Email
//
Month/Day/Year
//
Month/Day/Year
//
Month/Day/Year



If the envelope is lost, please send to:

RuthAnn Royer, AMC Sliffe Coordinator
American Math Competitions,
University of Nebraska- Lincoln,
1740 Vine Street,
Lincoln, NE 68588-0658.