Thomas Brennan Award Nomination Form

There are two methods available for submitting a nomination: 1. Fill out form online by typing into the text boxes. (Do not click on the "submit" button.) Print the form from your browser and send along with the additional materials listed below by 1 January of the nominating year to: Brennan Award Nominations Astronomical Society of the Pacific 390 Ashton Avenue San Francisco, CA 94112 2. Fill out the form online and click the submit button to send electronically. Then send the additional materials listed below via email as attachments, to awards {at} astrosociety.org with the nominee's name on the subject line by 1 January of the nominating year. 3. Additional required materials: Detailed letter of support by nominator, dated and signed (not just typed). Two additional detailed letters of support noting impact of nominee’s work, dated and signed (not just typed). Suggested persons for support: colleagues, parents, and students. Detailed resume of nominee, noting educational background, teaching locations and assignments, special astronomy education activities for schools and communities, curriculum innovations, past recognitions, and particular impact on student lives.

Name of nominee:
Address:
Address 2:
City:
State/Province:		Zip/Postal Code:
Country:
Phone:		Fax:
Email:

Name of person making nomination:
Address:
Address 2:
City:
State/Province:		Zip/Postal Code:
Country:
Phone:		Fax:
Email:

Signature of nominator: (N/A for online submissions)	__________________________________________________
Date:

Thomas Brennan Award Nomination Form

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