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Name _____________________________________________________    
 
Address   __________________________________________________
          
 
The purpose of the award is to call to public attention someone who has greatly
served the public schools and, through them, the children of Middlesex County. It
is also the purpose of this award to demonstrate that the MCEA and its members
believe that service to education is one of the highest forms of service anyone
can give.
 
To be a candidate for the award, the individual should be: any citizen or
organization living or working in Middlesex County and not a member of MCEA
shall be eligible to receive the award.
 
Written nominations may be made by any member or association on or before
March 15 of each year. Such nominations shall include reasons for the
nomination. 
            
 
Attach the essay to this form and return on or before March 15, 2012 to:  

      MCEA 2011 Scholarship Awards
       Middlesex County Education Association
       43 Brunswick Woods Drive
       East Brunswick, NJ  08816
            
 
MCEA MEMBER INFORMATION
 
Member’s Name: ________________________________Local  ______________   
(please print)
 
School/Building     _______________________________________
 
Member’s Signature  _____________________________________