Fillable NOMINATION FORM FOR USM AOP EDUCATIONAL ADMINISTRATOR OF (University of Southern Mississippi)

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NOMINATION FORM FOR USM AOP EDUCATIONAL ADMINISTRATOR OF (University of Southern Mississippi)

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NOMINATION FORM FOR USM AOP
EDUCATIONAL ADMINISTRATOR OF THE YEAR
Name: Current Position:
Number of years in current position: Campus address:
Supervisor’s name and title:
List previous positions held: (not necessarily limited to USM)
Title of Position Place of Employment From To
Years membership in: USM AOP: MAEOP: NAEOP:
Professional responsibilities in USM AOP (i.e., office(s) held, committee work, committee(s) chaired,
and dates of service):
Membership and activities in other organizations, include professional, community, and civic with
dates of service:
In-service training and/or university course work completed in the past two years:
Title Date
PSP recipient: Yes No If yes, level:
Signature of person making nomination Date
***If you nominate someone for this award, you are expected to attend the
Membership Recognition Luncheon.***
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NOMINATION FORM FOR USM AOP EDUCATIONAL ADMINISTRATOR OF (University of Southern Mississippi)

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Completed 30 August 2020

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