LSLA Nomination Form - Picture Links to Previous Nominators

Nominator Information
Select One:*
Full Name*

First NameLast Name
Nominator's Role:*

TeacherCounselorPrincipalAssistant Principal
School District:*
For private or charter schools, enter Private or Charter.
School Name*
Please type the full name of the school as it should appear on your nominee(s)' certificates.
School Mailing Address*

Mailing Address

Street Address Line 2

CityState

Zip Code
School Email*

Confirmation Email
Personal Email

Confirmation Email
Where would you like your nominees' packets to be mailed?*

To the students' home addresses.To me at my school address.
Are you nominating on behalf of another educator?*

NoYes
Who are you nominating on behalf of?*
Is this the first year you have nominated students?*

YesNo
How did you learn about Education in Action? (Select all that apply.)*

Email from Education in ActionNomination postcard in the mailTX Council for Social StudiesTX Assn. for Student CouncilsTX Elem. Principals and Supervisors Assn.TX Public Charter Schools Assn.TX State Historical Assn.TX Assn. for Gifted and TalentedTX Classroom Teachers Assn.From my Education Service CenterDiscover Texas Field Trip through Education in ActionTEA ListservColleague
Please confirm:*

I am not related to any of my nominees.
Nominees
Your nomination indicates your nominees demonstrate scholastic merit and leadership ability. To participate, students must:
- Be in the 4th, 5th, 6th, 7th, or 8th grade during the current school year
- Have a B (85% or 3.5) grade average or higher
- Show commitment to community or school involvement
- Demonstrate leadership ability
There is no limit to the number of students you may nominate.

Nominee’s names and addresses remain confidential and are not made available to third parties.

If you have a large number of students to nominate and would like to submit the data in another format (spreadsheet, class roster, etc.), you may do so below.
Nominate 10 or more students,

and we'll mail you this year's mascot plushy, Maggie the Mammoth! Nominate each year to collect them all!
How would you like to submit your nominations?*

I will type my nominees' information in this formI have a file to upload (spreadsheet, class roster, etc.)
Each nominee's name will be printed on a certificate as you have entered it.

Please take a moment to review your nominations for spelling and/or capitalization errors before submitting.
Please upload your file:*

Browse Files

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Nominee 1
Student Name*

First NameLast Name
Current Grade Level*
Student Address*

Street Address

Street Address Line 2

CityState

Zip Code
Select one:*

I have additional nominees to enter.I am ready to submit my nominees.
Nominee 2
Student Name*

First NameLast Name
Current Grade Level*
Student Address*

Street Address

Street Address Line 2

CityState

Zip Code
Select one:*

I have additional nominees to enter.I am ready to submit my nominees.
Nominee 3
Student Name*

First NameLast Name
Current Grade Level*
Student Address*

Street Address

Street Address Line 2

CityState

Zip Code
Select one:*

I have additional nominees to enter.I am ready to submit my nominees.
Nominee 4
Student Name*

First NameLast Name
Current Grade Level*
Student Address*

Street Address

Street Address Line 2

CityState

Zip Code
Select one:*

I have additional nominees to enter.I am ready to submit my nominees.
Nominee 5
Student Name*

First NameLast Name
Current Grade Level*
Student Address*

Street Address

Street Address Line 2

CityState

Zip Code
Select one:*

I have additional nominees to enter.I am ready to submit my nominees.
Nominee 6
Student Name*

First NameLast Name
Current Grade Level*
Student Address*

Street Address

Street Address Line 2

CityState

Zip Code
Select one:*

I have additional nominees to enter.I am ready to submit my nominees.
Nominee 7
Student Name*

First NameLast Name
Current Grade Level*
Student Address*

Street Address

Street Address Line 2

CityState

Zip Code
Select one:*

I have additional nominees to enter.I am ready to submit my nominees.
Nominee 8
Student Name*

First NameLast Name
Current Grade Level*
Student Address*

Street Address

Street Address Line 2

CityState

Zip Code
Select one:*

I have additional nominees to enter.I am ready to submit my nominees.
Nominee 9
Student Name*

First NameLast Name
Current Grade Level*
Student Address*

Street Address

Street Address Line 2

CityState

Zip Code
Select one:*

I have additional nominees to enter.I am ready to submit my nominees.
Nominee 10
Student Name*

First NameLast Name
Current Grade Level*
Student Address*

Street Address

Street Address Line 2

CityState

Zip Code
Select one:*

I have additional nominees to enter.I am ready to submit my nominees.
Nominee 11
Student Name*

First NameLast Name
Current Grade Level*
Student Address*

Street Address

Street Address Line 2

CityState

Zip Code
Select one:*

I have additional nominees to enter.I am ready to submit my nominees.
Nominee 12
Student Name*

First NameLast Name
Current Grade Level*
Student Address*

Street Address

Street Address Line 2

CityState

Zip Code
Select one:*

I have additional nominees to enter.I am ready to submit my nominees.
Nominee 13
Student Name*

First NameLast Name
Current Grade Level*
Student Address*

Street Address

Street Address Line 2

CityState

Zip Code
Select one:*

I have additional nominees to enter.I am ready to submit my nominees.
Nominee 14
Student Name*

First NameLast Name
Current Grade Level*
Student Address*

Street Address

Street Address Line 2

CityState

Zip Code
Select one:*

I have additional nominees to enter.I am ready to submit my nominees.
Nominee 15
Student Name*

First NameLast Name
Current Grade Level*
Student Address*

Street Address

Street Address Line 2

CityState

Zip Code
Select one:*

I have additional nominees to enter.I am ready to submit my nominees.
Nominee 16
Student Name*

First NameLast Name
Current Grade Level*
Student Address*

Street Address

Street Address Line 2

CityState

Zip Code
Select one:*

I have additional nominees to enter.I am ready to submit my nominees.
Nominee 17
Student Name*

First NameLast Name
Current Grade Level*
Student Address*

Street Address

Street Address Line 2

CityState

Zip Code
Select one:*

I have additional nominees to enter.I am ready to submit my nominees.
Nominee 18
Student Name*

First NameLast Name
Current Grade Level*
Student Address*

Street Address

Street Address Line 2

CityState

Zip Code
Select one:*

I have additional nominees to enter.I am ready to submit my nominees.
Nominee 19
Student Name*

First NameLast Name
Current Grade Level*
Student Address*

Street Address

Street Address Line 2

CityState

Zip Code
Select one:*

I have additional nominees to enter.I am ready to submit my nominees.
Nominee 20
Student Name*

First NameLast Name
Current Grade Level*
Student Address*

Street Address

Street Address Line 2

CityState

Zip Code
If you have additional nominees to enter, please submit the form and click the link under the green check mark to continue.
Review and Submit
Each nominee's name will be printed on a certificate as you have entered it. Please take a moment to review your nominations (scroll up) for spelling and/or capitalization errors before submitting.

You will receive a list of your nominees via email, or you can print a copy of this form using the button below - just make sure to come back and click Submit!
Should be Empty:

Nominator Information

Nominees

Nominate 10 or more students,

Nominee 1

Nominee 2

Nominee 3

Nominee 4

Nominee 5

Nominee 6

Nominee 7

Nominee 8

Nominee 9

Nominee 10

Nominee 11

Nominee 12

Nominee 13

Nominee 14

Nominee 15

Nominee 16

Nominee 17

Nominee 18

Nominee 19

Nominee 20

Review and Submit