Anishinabek Education System Educator Excellence Award Two (2) scholarships in the amount of $1,500 each will be awarded to recipients who play an exceptional role in educating Anishinabek students, positively impact the well-being of Anishinabek youth, and encourage students to pursue their individual talents and interests. NOMINATION FORM Name of Nominee: Participating First Nation: Nominated by: Nomination Criteria Nominee must be a registered member of a Participating First Nation of the Anishinabek Education System (see list below). Nominations must include the attached form and be accompanied by a letter of support from the Chief and Council of the nominee’s community CLOSING DATE FOR NOMINATIONS IS FRIDAY, MAY 28, 2021 Selection Criteria All applications are received and reviewed by the Anishinabek Nation 7th Generation Charity to ensure nomination-qualification criteria is met. Nominators will be contacted if further information is required. Successful recipients will be notified via telephone and by official letter. Successful recipients are required to provide a ‘high quality’ electronic photo which will be used for publication purposes. Applicant Contact Information Name Address Email Telephone Number Please indicate which Participating First Nation the nominee is registered to: ☐ Aamjiwnaang First Nation ☐ Michipicoten First Nation ☐ Atikameksheng Anishnawbek ☐ Mississaugas of Scugog Island First Nation ☐ Aundeck Omni Kaning First Nation ☐ Moose Deer Point First Nation ☐ Beausoleil First Nation ☐ Munsee-Delaware Nation ☐ Biigtigong Nishnaabeg ☐ Nipissing First Nation ☐ Biinjitiwaabik Zaaging Anishinaabek ☐ Pic Mobert First Nation ☐ Chippewas of Georgina Island First Nation ☐ Sheshegwaning First Nation ☐ Chippewas of Rama First Nation ☐ Wahnapitae First Nation ☐ Dokis First Nation ☐ Wasauksing First Nation ☐ Henvey Inlet First Nation ☐ Whitefish River First Nation ☐ Long Lake #58 First Nation ☐ Zhiibaahaasing First Nation ☐ Magnetawan First Nation Please indicate what role the nominee has in the community: ☐ Teacher/Principal ☐ Education Assistant ☐ Elder ☐ Knowledge Keeper ☐ Language Speaker ☐ Mentor ☐ Other: __________________________________________ How long has this person worked in education or played a role in educating Anishinabek students? ________________________________________________________ ________________________________________________________ ________________________________________________________ Please tell us about the achievements this person has made in educating youth in your community: ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ Please describe how this person contributes to school and/or community goals: ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ Other details/comments/information you would like to share about this person: ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ ________________________________________________________ Please provide two references to support your nomination, along with their contact information: Reference 1 Name ______________________________ Telephone ______________________________ Email ______________________________ Reference 2 Name ___________________________ Telephone ___________________________ Email ___________________________ Nominator Contact Information Name: __________________________________________________________ Mailing Address: __________________________________________________ Participating First Nation: ___________________________________________ Telephone: _______________________________________________________ Email: ___________________________________________________________ Please indicate if a letter of support from Chief and Council is attached: ☐ YES ☐ NO APPLICATIONS CAN BE SUBMITTED BY EMAIL (preferred), MAIL, OR FAX TO: Jason Restoule, Manager Anishinabek Nation 7th Generation Charity 1 Migizii Miikan, P.O. Box 711, North Bay, ON P1B 8J8 Phone: (705) 497-9127 or 1-877-702-5200 Fax: (705) 497-9135 Email: [email protected] www.an7gc.ca .