KCSS 2017 Award Nomination Form
Please complete this form to nominate yourself or a fellow teacher for the Kansas Council for the Social Studies Judy Cromwell Excellence in Teaching Award. After completing the nomination form please be sure to send the other required documents to complete the nomination process through electronic or snail mail.

These include:

-Professional Resume
-1-2 page letter from the applicant/nominee
-2 additional letters of support.
-Please visit kcss.info for more detail information on what constitutes a complete nomination packet

Email or mail the above documents to:

cassmedley@gmail.com

Cassie Medley
403 Topeka Ave
Paxico, KS 66526

Email address *
Please check the box next to the grade level award that this application is for: *
Nominee Information
First Name *
Your answer
Last Name *
Your answer
Address *
Your answer
City, State, Zip Code *
Your answer
Phone Number *
Your answer
Email Address *
Your answer
Nominator Information (if not self-nominated)
First Name *
Your answer
Last Name *
Your answer
Address *
Your answer
City, State, Zip Code *
Your answer
Phone Number *
Your answer
Email Address *
Your answer
Nominee's School Information
School Name *
Your answer
School District *
Your answer
Address *
Your answer
City, State, Zip Code *
Your answer
Phone Number *
Your answer
THIS DOES NOT COMPLETE THE NOMINATION PROCESS
After completing the nomination form please be sure to mail in the other required documents to complete the nomination process. These include:

-Professional Resume
-1-2 page letter from the applicant/nominee
-2 additional letters of support.
-Please visit kcss.info for more detail information on what constitutes a complete nomination packet

Email or mail the above documents to:

cassmedley@gmail.com

Cassie Medley
403 Topeka Ave
Paxico, KS 66526

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