WARREN W. EUKEL TEACHER TRUST
2125 Oak Grove Road, Suite 120
Walnut Creek, CA 94598
Telephone: (925) 945-0200
Facsimile: (925) 945-8792
2012 NOMINATION FORM FOR:
Home Address:__________________________ School Address:__________________________
Home Phone:____________________________ School Phone:____________________________
Home Email:____________________________ School Email:____________________________
Number of Years Teaching ________________
Dear Eukel Teacher Trust Selection Committee:
I hereby nominate the above-referenced person to be a recipient of this year’s $10,000 award for
excellence in education.
1. Why does this nominee deserve to be named one of this year’s most outstanding teachers in
Contra Costa County?
2. Describe one way in which this teacher has changed the lives of his/her students.
3. In what ways has this nominee done more than what is normally expected of a teacher?
Nominated by: __________________
Address: _______________________ Please fax or mail to the Eukel Trust by May 24th
_______________________ (Feel free to attach additional pages to this form)