SWE Certificate of Merit Nomination Form (FY11-12)
Please provide the following information:
Name of School: ___________________________________________________________
Phone number: (_____) _______________________________________
Email address: ______________________________________________________
Contact person: ____________________________________________________________
Date of Awards Assembly: ___________________________________________________
(Required field, as this date will appear on the certificate)
The certificates will be sent to the contact person at the school. Please submit this request form as
an email attachment, 4 weeks in advance of your presentation, or by April 1, 2012 (whichever is
earlier) to Mary Whalon at firstname.lastname@example.org. In return, all submitters will
receive an email acknowledgement as a confirmation.
Please indicate below the young women you have selected for Certificates of Merit. Certificates read
“SWE certificate of merit for (__Honor) in science and mathematics, presented to (name) in
recognition of three years’ excellence in these courses”.
1. With Highest Honor
2. With High Honor
3. With Honor
If it can be arranged and your school is in Colorado, would you want a SWE representative to present
the certificate(s) at the awards assembly? If neither box is marked, it is assumed the response is
If a SWE representative is available to present the certificate (s) at the awards assembly, the school
will be contacted at least one week in advance of the event for the assembly details.
Please submit this form as an email attachment to: For questions, please contact:
Mary Whalon at Mary Whalon at (303) 909-1886