2017-2018

SHAPE America JRFH & HFH Recognition Award Application

2017-2018

SHAPE America JRFH & HFH

Recognition Award Application

Heart-healthy schools are fueled by effective health and physical education and support 50 Million Strong by 2029, SHAPE America's vision to empower all students to live healthier lives.

Criteria
Applicants must:
·  Be a current member of SHAPE America.
·  Have a minimum of three years of experience as a Jump Rope For Heart/Hoops For Heart event coordinator.
·  Maintain professional growth within the field of P.E., P.A. and/or Health Education.
·  Serve as a positive role model, epitomizing personal health and fitness, enjoyment of activity and sportsmanship as well as sensitivity to the needs of all participants.
·  Demonstrate leadership and commitment to the Jump Rope For Heart and/or Hoops For Heart program by serving on JRFH/HFH committees, as a demonstration team coach or as a state or district coordinator, and/or by presenting JRFH/HFH workshops or programs.
·  Submit a complete, typed application free of errors and typos by email by the deadline.
·  Previous JRFH and HFH Recognition Award recipients and Joint Projects Committee members are not eligible to apply.

SHAPE America – The Society of Health and Physical Educators is proud of its over 39 -year partnership on Jump Rope For Heart (JRFH) and Hoops For Heart (HFH) with the American Heart Association. Each year SHAPE America recognizes up to two JRFH or HFH coordinators to receive the prestigious SHAPE America JRFH/HFH Recognition Award. Award winners exemplify leadership in the JRFH and HFH programs at the state, district or national level. These individuals are recognized at the SHAPE America National Convention Awards Ceremony where they are honored in front of their peers for their dedication and commitment to the programs.

How to Apply
·  We will only accept applications that are submitted electronically. Please email your application to Yasmeen Taji-Farouki at .
·  SHAPE America does its best to respond to all applications but, due to the large amount of proposals received, we cannot guarantee that you will receive a confirmation of receipt.
·  All applications must be received no later than 12 a.m. EST on November 1st, 2017.
·  Applicants will be notified in January. Award recipients will be announced via email, in The Pulse, and on www.shapeamerica.org.
If you have any questions regarding the JRFH/HFH award program please contact
Yasmeen Taji-Farouki at .
Application Components
Part I. Official Application Form
Part II. Curriculum Vitae (maximum 10 pages)
Part III. Two Letters of Recommendation (one must be from a SHAPE America member)

Part I. Applicant Information Form

Coordinator Contact Information
Name / Click here to enter text.
Email / Click here to enter text. / Phone / Click here to enter text.
School Information
School / Click here to enter text. / No. of Students in School / Click here to enter text.
Street Address / Click here to enter text.
City / Click here to enter text. / State / Click here to enter text. / Zip / Click here to enter text.
Principal’s Name / Click here to enter text.
Principal’s Email / Click here to enter text.
Membership
SHAPE America Member ID / Click here to enter text. / Are you a member of your state association? / Yes ☐
No ☐
No. of Years as SHAPE America Member / Click here to enter text. / No. of Years as State Association Member / Click here to enter text.
JRFH/HFH Event Information
List your Leadership and Awards Related to JRFH and/or HFH
Ex: Session presentations at conferences, mentorship, district leader, presentations to department/ district. / Click here to enter text.
Which event do you hold? / JRFH ☐ HFH ☐ Combo ☐
Date of Last Event / Click here to enter a date. / No. of Years Holding JRFH and/or HFH event(s) / Click here to enter text.
Name of AHA Youth Market Director / Click here to enter text.
Growth of JRFH/HFH Event
Year / Click here to enter text. / # of student involved / Click here to enter text. / Funds raised / Click here to enter text.
Year / Click here to enter text. / # of student involved / Click here to enter text. / Funds raised / Click here to enter text.
Year / Click here to enter text. / # of student involved / Click here to enter text. / Funds raised / Click here to enter text.
Jump Rope For Heart Demonstration Team
Fill out this information ONLY if it applies to you.
Do you coach a JRFH Demonstration Team? / Yes ☐
No ☐ / No. of Years Coaching Demonstration Team / Click here to enter text.
How many demos does your team do a year? / Click here to enter text. / How many members are on the team? / Click here to enter text.
List some of your team’s recent performances, with dates. / Click here to enter text.
Additional Questions
Describe your collaboration efforts on JRFH/HFH with SHAPE State Affiliations, AHA Staff, and other groups. / Click here to enter text.
Describe any creative, innovative, or unique ideas incorporated into your JRFH/HFH event(s). / Click here to enter text.
Explain your passion and commitment to physical activity and physical education and how JRFH/HFH play a role. / Click here to enter text.
Describe your involvement with JRFH/HFH at the local level beyond you school event (city-wide, recruitment efforts, etc.). / Click here to enter text.
Describe your involvement in JRFH/HFH at the state and/or national level (state task force, presentations, newsletters, Joint Projects Committee, etc.). / Click here to enter text.

Part II. Curriculum Vitae

Please submit your curriculum vitae as a PDF file, no more than 10 pages long. Include professional affiliations, committees, professional development, activities, and awards or honors related to the following: JRFH, HFH, SHAPE America and any of its state associations, and American Heart Association.

Part III. Two Letters of Recommendation

Provide two (2) letters of support from nominators. One nominator must be a current SHAPE America member. Letters should specifically address the criteria for the award and how the nominee qualifies.

Nominator 1
Name of Nominator / Click here to enter text. / Relation / Click here to enter text.
Membership # / Click here to enter text. / Email / Click here to enter text.
Nominator 2
Name of Nominator / Click here to enter text. / Relation / Click here to enter text.
Membership # / Click here to enter text. / Email / Click here to enter text.

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