Upstate Diversity Leadership Awards Nomination Form

For which award category are you submitting a nomination?

Please note: An additional category may be awarded by the selection committee to a nominee who positively contributes to promoting international diversity in the Upstate in an extraordinary way. If so, the nominee will be chosen from those nominated for the above categories.
Your Contact Information
Your name Your name First Last
Your phone number Your phone number - ### - ### ####
Your organization, if applicable
Your position or title, if applicable
Your email
Nominee Contact Information
Nominee's name Nominee's name First Last
Nominee's organization or school
Nominee's position or title, if applicable
Nominee's mailing address Nominee's mailing address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Nominee's phone number Nominee's phone number - ### - ### ####
Nominee's email address
About the William “Bill” T. Wylie VALUED Lives Award for School Excellence in Diversity

This award recognizes excellence in diversity by acknowledging the valued practices (listed below) in K-12 schools. Schools have the ideal opportunity to foster diversity and encourage the personal and interpersonal development of all students, families, teachers, staff, and communities. To be considered for this award, schools have recognized the following practices:

V—encouraging VALUE for personal expression and experience
A—fostering AWARENESS and self-reflection
L—promoting LEARNING and inclusive teaching
U—UNITING communities by involvement and service
E—demonstrating EQUITY in the school’s programs, staff, and practices
D—engaging in continuous DIALOGUE and meaningful interactions

Schools receiving this award have done an outstanding job in weaving these principles into its vision and mission and have promoted these principles beyond the walls of the school, demonstrating that all individuals are important and have the potential to be significant contributors to the Upstate community and beyond.
School Information

This is the description of your section break.
School name
School mailing address School mailing address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
School phone number School phone number - ### - ### ####
School fax number School fax number - ### - ### ####
School website
School contact person name School contact person name First Last
School contact person's phone number School contact person's phone number - ### - ### ####
School contact person's email address
About the Nominee
If you wish, you may upload a recent photograph of the nominee.

Attach Files
Provide a brief statement of the diversity contributions and specific activities of the nominee.
Maximum of 250 words allowed. Currently Entered: 0 words.
Identify the nominee’s leadership roles, honors and achievements related to diversity endeavors.
(For business or non-profit applicants, describe the organization’s honors and achievements in the community)
Maximum of 250 words allowed. Currently Entered: 0 words.
Describe all other civic/community involvement, particularly as related to enhancing and/or promoting diversity.
Maximum of 250 words allowed. Currently Entered: 0 words.
For business and nonprofit nominations only: Discuss the training, development, and/or support services provided to employees and clients, in order to develop or create diversity leaders.
Maximum of 250 words allowed. Currently Entered: 0 words.
For business and nonprofit nominations only: Provide a brief overview of the organization, including the mission and clientele focus.
Maximum of 250 words allowed. Currently Entered: 0 words.
Additional comments, information, or supporting documentation:
Maximum of 250 words allowed. Currently Entered: 0 words.
About the School
If you wish, you may upload a recent photograph of the nominee.

Attach Files
Provide a brief statement of the diversity contributions and specific activities of the school, with supporting documentation.
Maximum of 250 words allowed. Currently Entered: 0 words.
Discuss the professional development, programs, initiatives, and/or support services provided to students and employees, in order to increase diversity awareness.
Maximum of 250 words allowed. Currently Entered: 0 words.
Identify the school’s previous accomplishments, achievements, and/or honors related to diversity endeavors.
Maximum of 250 words allowed. Currently Entered: 0 words.
Describe how the school’s diversity initiatives have impacted the school environment.
Maximum of 250 words allowed. Currently Entered: 0 words.
Provide a brief description of the sustainability of your school’s diversity initiatives including future long term plans.
Maximum of 250 words allowed. Currently Entered: 0 words.
Additional comments, information or supporting documentation:
Maximum of 250 words allowed. Currently Entered: 0 words.
References for Nominee

If you wish, provide references for your nominee below.
Reference #1: Name Reference #1: Name First Last
Reference #1: Phone number Reference #1: Phone number - ### - ### ####
Reference #1: Email address
Reference #2: Name Reference #2: Name First Last
Reference #2: Phone number Reference #2: Phone number - ### - ### ####
Reference #2: Email address

Upstate Diversity Leadership Awards Nomination Form

Upstate Diversity Leadership Awards Nomination Form

Your Contact Information

Nominee Contact Information

About the William “Bill” T. Wylie VALUED Lives Award for School Excellence in Diversity

School Information

About the Nominee

About the School

References for Nominee