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Wayne Parker Advocate of the Year Award Nomination Form
This award honors an individual who has demonstrated exceptional use of TNSTEP’s resources and information to help a child—whether their own or another's—access a free and appropriate public education. The nominee should embody teamwork and collaboration, along with a passion for sharing the knowledge they’ve gained with others. Ideal candidates may include parents of children with disabilities, advocates working alongside families, educators who have made a significant impact in the life of a student with a disability, or service providers who have played a key role in connecting students and their families with necessary resources to ensure they receive a quality education.
Date
Nominees Name
*
First Name
Last Name
Nominees Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Nominees County
*
Nominees E-mail
*
Nominees Phone Number
*
-
Area Code
Phone Number
Nominees Cell Number
-
Area Code
Phone Number
Please check one:
*
Parent/ Guardian
Professional
Role in the Student’s Life:
*
(Example: parent, caregiver, advocate, teacher, service provider, etc.)
Short essay describing why this nominee is deserving of recognition.
*
Please Note: Do not give confidential information about the student unless permission has been given from nominee. Use broad terms such as: has a young child, middle school age child, etc., from East, Middle, or West TN.)
0/250
Include a photo of the nominee (jpg format)
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Nominated by:
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Email
example@example.com
CLICK HERE to submit your nomination
Should be Empty: