POTY Nomination Form


Program of the Year Nomination Form
Michigan Speech-Language Hearing Association
requests Exemplary Program Nominations

The MSHA Public School Committee requests nominations for Speech, Language, and/or Hearing Programs to be recognized.  A program (which includes at least one MSHA member) may be nominated by anyone who feels it is deserving of statewide recognition.  Please complete this form and return it to the MSHA office.  The Public School committee will review all nominations and select several programs for possible on-site review.  Thank you!  Please see reverse for Guidelines.

Please type or print legibly.

Program Name:__________________________________________________________________________

School District:______________________________________ Phone: (____)_________________________

Address:__________________________________________________________________________________

____________________________________________________________________Zip Code:_____________

Fax:_______________________________________ Email address:_________________________________

Primary person(s) providing services for this program and their title/position:

__________________________________________________________________________________________

Any other person(s) to be included in this nomination:_________________________________________

Brief description (disability area, ages of students, etc.):_________________________________________
__________________________________________________________________________________________

Please list 5 qualities which you feel make this program exceptional (attach an additional sheet if necessary).
_________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________

Nominated By:____________________________________________________________________________

Address:__________________________________________________________________________________
__________________________________________________________________________________________

Phone (day & evening):(______)_____________________________(______)_________________________
Superintendent responsible for this program:________________________________________
Phone: (w)__________________________________
        
Deadline for Nominations: January 15, 2016


Guidelines for
MSHA’s Program of the Year Award

It is the intent of the Public School Committee’s (PSC) Program of the Year Award to accomplish the following:

1.  Give visible recognition to outstanding speech, language, and hearing programs in the public schools of Michigan and to those persons responsible for their development and implementation.

2.  Promote and share quality professional programs with our colleagues in the schools statewide; and to motivate individuals and departments to enrich their own programs.  In short - a morale booster.

3.  Highlight our profession in the media in a highly visible manner for positive public relations with the citizenry of our state, thereby strengthening our public support for improving programs in the public schools.

This project is an annual event wherein recognition is given to one or more programs.  Extensive coverage will be given to the program(s) both internally at the MSHA Conference and in MSHA publications, as well as in the media via newspapers, interviews on radio and television, articles and press releases.

For purposes of participation in this project, program is defined as follows:

Any provision of service to the speech, language and hearing impaired in the schools.  This can include an entire department, a sub-unit of a department, an itinerant program, a clinic, an individual professional’s program in one school or in one classroom.  It might be a multi-professional team effort.  It could be a department from a large city district or one individual professional’s program from an Upper Peninsula village.  At least one individual participating in the program must be a MSHA member.

The procedure for participating is as follows: nominations may be made by anyone - parent, colleague, administrator.  Nominations must be submitted on the reverse of this form.  Nominations will be reviewed by the Program of the Year Committee.   Additional information may be elicited from the finalists and possibly an on-site visit conducted.

* * * * * * * * * * * *

 

Deadline: January 15,  2016 - so that this year’s exceptional program may be honored at the
2016 MSHA Conference Awards Luncheon, Friday, April 22, 2016. 
The MSHA Conference runs from April 21-23, 2016 at the Amway Grand Plaza Hotel
in Grand Rapids, Michigan.