SEI Award Nomination Form

Name of Nominee*

First Last

Nominee Email*

Phone*

Nominee's Address*

Street Address City State ZIP Code

Age

Year of Nomination

OHSVCA District Number*

School Affiliation*

School Name Address City State ZIP Code

School Phone*

Coaching Experience*

School	Dates

Nomination Criteria

Examples of how the Nominee is a positive role model for others*

Examples of unwavering commitment to good sportsmanship*

Examples of high level of ethics and integrity in carrying out all professional responsibilities*

Examples of how Nominee teaches positive values by words and deeds*

Examples of how Nominee has faithfully served the youth of Ohio*