State Tech Champion Nomination

Name of Nominee*

First and Last Name
Job Title
In what ways has the nominated employee gone above and beyond? (please give examples)*
How does the nominated employee show commitment to State Tech?*
How does the nominated employee empower excellence inside and outside of the classroom? (Faculty Nomination Only)
Only complete the box above if you are nominating a faculty member.
How does the nominated employee empower excellence in their daily work? (Staff Nomination Only)
Only complete the box above if you are nominating a staff member.
How does the nominated employee deliver a positive student experience?*
Why does the nominated employee deserve this award?*
Nominated By (your name):

First and Last Name
Your Email
Your Phone
May we publish your name?

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