Application for the 25th Annual Secretary's Award
for Excellence in Energy and Environmental Education

Nomination Form

Nomination Application Instructions

Remit completed nomination form to: Meg Colclough
By Email:Meg.Colclough@state.ma.us
By Mail:Executive Office of Energy and Environmental Affairs
Attn: Meg Colclough
100 Cambridge Street, Suite 900
Boston, MA 02114
By Fax:617-626-1027, Attn: Meg Colclough

1. For EEA Awards information, and examples of previous award winners click here.

2. Please fill out the Nomination Form and attach additional sheets if necessary.

3. All nominations must be received in complete form no later than close of business day, March 30, 2019.

4. Failure to meet the application deadline or incomplete submittals will result in disqualification.

Nominator Contact Information:

Nominator Contact Person:

Address:

City:

State:

Zip Code:

Phone:

Email:

Nomination Information:

I am nominating the following student, teacher, program or school/organization for the Secretary’s Award for Excellence in Energy and Environmental Education. Please fill this information out completely.

NOMINEE:

School or Organization:

Program or Project Name:

Grade Level(s):

School Tax I.D. Number:

School Vendor Number:

School/Organization Street Address:

City:

State:

Zip Code:

Contact Person Phone:

Contact Person Email:

Local Newspaper(s) for the Nominee:

Applicable Award Classifications:

Nominee Category: (check one)

Individual

Organization

Sector: (check one)

Massachusetts K12 School	Massachusetts K12 Teacher
Nonprofit K12 Educator	Massachusetts Student(s)

Method: (check any that apply)

Project

Program

Applicable Achievement Classifications: (Does your project/ program involve energy-related education?)

Application: (check any that apply)

Energy Efficiency	Energy Conservation	Renewable Energy
Not Applicable

Please write a "Summary Statement" of the nomination, highlighting the significance of the achievement and the energy and/or environmental benefits you believe qualifies this nomination for an award. Include the name of the project/activity.

As part of the Summary Statement, please include the following information if it is relevant to the project:

Innovation: (Describe what is creative or original about this program.)
Audience: (What audience does the project/program reach?)
Use of Local resources: (Tell us how the project/program used local community resources as an avenue for promoting the program and/or educating students about energy and the environment? Tell us about your collaboration with community partners, resources such as watershed associations, non-profits, utilities, state agencies or others.)
Partnerships: (Describe partnerships that support the program. Examples include, but are not limited to: utilities, non-profits, museums, conservation groups, municipalities, colleges, etc.)
Funding Sources & Sustainability: (i.e. How does the program sustain itself? How will it continue?)
How many students participated?
Replicable (Could this program serve as a model in other settings?)
Civic/Community Responsibility (How does this program develop decision-making, citizenship skills, and civic responsibility?)

Summary Statement: (Summary Statment must be at least 300 words. Please enter details of your program for evaluation.)

Application for the 25th Annual Secretary's Awardfor Excellence in Energy and Environmental Education

Nomination Form

Nomination Application Instructions

Nominator Contact Information:

Nomination Information:

Application for the 25th Annual Secretary's Award
for Excellence in Energy and Environmental Education