Aliorum De Award-Nomination Form
Due by March 15, 2019. You must complete this form in its entirety before submitting.
Name of nominee
Nominee's grade, position, or role within the LPSD community:
Name of nominee's school
Bear Creek Elementary School
Lewis-Palmer Elementary School
Palmer Lake Elementary School
Prairie Winds Elementary School
Ray Kilmer Elementary School
Lewis-Palmer Middle School
Monument Academy Charter School
Lewis-Palmer High School
Palmer Ridge High School
Name of nominees's supervisor or teacher (if applicable)
Please provide YOUR name for any questions and for an invitation to the celebration.
Your phone number:
Please provide your phone number so we can contact you. Include your area code.
Are you a:
In 400 words or less, please describe how you believe this person has made a difference in the life of a student with a disability. Tell a story with specific details describing why this person should be chosen as an Aliorum De Award recipient. For example, stories may include but are not limited to examples around what he or she does to support inclusion or authentic friendship, to ease daily transitions, or to support the unique learning environment of a student with a disability. In addition, please summarize your nomination by stating in one sentence why you feel that the nominee deserves this award.
You may type your answer or copy and paste in the space below.
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