Please Type

Nominee's Name (First name first): __________________________________________________

College or University Affiliation: __________________________________________________

College or University Address: ______________________________________________________

City: ____________________________________________ State: ________ Zip: _____________

Nominee's number of years teaching experience in a mathematical science:_____________

Has the nominee taught at least halftime in a mathematical science during the current academic year or during the previous year if on approved leave or sabbatical? _______

In the space below, please briefly describe the unusual personal and professional qualities of the nominee that contribute to his or her extraordinary teaching success.

Name of Nominator (first name first): _______________________________________________

Address of Nominator: _______________________________________________________________

Telephone: _______________________________ Email: ___________________________________

Nominator's Signature: ______________________________________________________________

Evidence of Success in Teaching:

A nomination for this award should consist of only the materials requested below, and should not include any other materials such as curricula vitae or other items. Please prepare all application materials on one side only of 8.5 X 11 inch paper, with a type size no smaller than 12 points (pica).

A complete application should contain the following items:

Nomination Form: The completed Nomination Form should form the first page of the application.

Narrative: Please describe the nominee's success in teaching by providing a narrative of the nominee's background, experience, teaching style, special contributions, other teaching awards, and any additional related information. Please limit this portion to no more than five double-spaced pages.

Additional Documentation: Please submit no more than three pages of evidence to document the nominee's extraordinary teaching success. This documentation will vary greatly from institution to institution but may include summaries of peer or student evaluation, comments on teaching, possible increases in numbers of undergraduate or graduate degrees given in mathematics (with clear evidence of the nominee's substantial responsibility for them), possible student successes in mathematics competitions (with clear evidence of the nominee's substantial responsibility for them), etc.

Letters of Recommendation: Please include no more than five letters of recommendation of no more than one page each, as follows.