Awards Application

Award applicants who meet the requirements and exemplify the criteria for the ND SHAPE awards may apply or be

nominated by a colleague or individual.

All award nominees must be a ND SHAPE member.

Award winners and nominees will be notified by a member of the ND SHAPE Awards Committee once a selection has

been made. Further details will be provided to you upon request or selection.

Applications received by July 1 will be considered for the current year.

Includes the following awards: College/University Physical Educator of the Year, College/University Health Educator of the Year, Administrator of the Year, Athletic Director of the Year, ND SHAPE Honor Award, Donna Terbizan Meritorious Award. Your submission will be emailed to our Awards Chairperson, Nicole Lindgren. If you would like to confirm the receipt of your submission, please contact Nicole at lindgren.nicole@gmail.com.

Nomination Category*
Your Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email
Employed by:
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Current Position
- Elementary Physical Education
- Middle School Physical Education
- High School Physical Education
- Health Educator
- Dance Educator
- Adapted Physical Education
- Administrator
- Athletic Director
Career Information
Position Location Length of Service
Career Information
Position Location Length of Service
Career Information
Position Location Length of Service
Grade Levels Taught
- Elementary
- Middle
- High School
- Undergraduate
- Graduate
Serves as a positive role model epitomizing personal health and fitness, enjoyment of physical activity, and sensitivity to the physical and emotional needs of all students.
Participates in professional development opportunities.
Please list any significant achievements in the fields of Health, Physical Education, Recreation and Dance by the nominee.
Professional positions, offices, committee memberships held by nominee.
Professional contributions: research, speeches, journal articles, etc from nominee.
Professional organization memberships

Position	Location	Length of Service

Position	Location	Length of Service

Position	Location	Length of Service