McTavish Nomination Form

OSSTF District 11- Thames Valley
Ontario Secondary School Teachers' Federation
680 Industrial Road, London, Ontario, N5V 1V1
Phone: (519) 659-6588; Fax: (519) 659-2421; Email: osstf11@execulink.com

E.C. McTavish Award Nomination Form

Instructions:

Please fill in as much information as possible under each area below, keeping in mind the following selection criteria. A suitable nominee is:

	A student who is in the final, graduating year of his/her program at a Secondary School, and who is either post-secondary bound or strongly employable.
	A student who has done his/her best while overcoming some significant difficulties.
	A student, who perhaps has had to do part-time work while in Secondary School, and therefore has not been able to participate in as many extra-curricular activities as others.
	The intent is to recognize a worthy, striving student who has contributed to the school and community, but has not been, nor will likely be, the recipient or nominee of other awards.

Please note that the nominee may wish some information to be kept confidential; these should be noted in section "G". If this student is selected as the award recipient, confidentiality must be respected when the script is written.

Nominee:____________________________________________________________

Nominated by:________________________________________________________

School Involvement

School Participation/Effort (do not include marks)

Community Involvement

Work Experience

Future Plans (education/career)

Difficulties Overcome

Confidentiality Notes (Please note items from any section above which should be kept confidential)

Signature of student being nominated acknowledging acceptance of the nomination:

________________________________________________________