Important Update 2020: add your signature to Outstanding High School Chemistry Student Certificates
To High School Chemistry Teachers and Science Teachers who teach chemistry

To add an electronic signature to the certificates GO TO: "How to create an electronic signature from an iPhone" to create your electronic signature. Upload your signature to a cloud platform (googledocs, etc) that has a URL: Be sure to SHARE the viewing properties.

View an example of certificates with electronic signature certificates at

Select Delivery option: as one merged file or in a folder with each certificate as a separate file.

If you already have completed this form and have received your certificates you may 1. have the certificates redone with your signature per instructions below; or 2. make no change.

The Portland Section of the American Chemical Society (Portland Section ACS) provides certificates to teachers to assist in recognizing outstanding chemistry students. The Portland Section prepares a certificate for each student named on this form and will email the certificates to the teacher for presentation to students.

When you are finished, click the SUBMIT button at the bottom to SEND.

All Responses to this form are sent to Portland Section ACS.

Deadline for nominations is Sept 30, 2020

Please forward this form [] to colleagues who teach high school chemistry.

Best regards,
Martha GK Dibblee, Coordinator
HS Outstanding Chemistry Student Certificate Program
Portland Section ACS
Electronic signature
If you want an electronic signature on each certificate, follow the instruction above and provide the URL below. Make sure to share the URL after you make it in googledocs!
TEACHER'S contact information
Teacher Name, Complete School Name, mailing address
Ignore if you've alread submitted names. List names below. You may submit up to 12 names. You also may designate a specific class e.g., IB chemistry or AP chemistry or by class or period.
Delivery Options
Certificates will be EMAILED TO YOU. Check the box below if you want certificates in a folder as separate files or as one merged file
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