Application Process for Normandy: Sacrifice for Freedom®
Albert H. Small Student and Teacher Scholars
The teams will be selected by the National History Day committee based on the following materials:

The teacher and student information sheets. Complete with teacher, student, and parent signatures.

The teacher's resume (2 pages max).

An essay explaining the teacher’s interest in the institute, stating the applicant's philosophy of teaching, including
how students are engaged in historical research in the classroom now (2 pages, double-spaced max).

A list of the teacher’s current classes and grade level(s) being taught.

A letter of support from the teacher’s supervisor that attests to employment status in 2016-2017 and agreeing to
the applicant's making two presentations and participating in National History Day beginning in the fall 2016.

Student and teacher medical forms.

A letter of introduction of the selected student by the teacher that addresses who the student is academically and
why this particular student was chosen to be your team member.

The student essay, which addresses why he/she should be considered, what sets him/her apart from his/her peers,
and how he/she will use this opportunity (2 pages, double-spaced max).
Please scan all materials, compile into one PDF file, and email to programs@nhd.org. Applications will be acknowledged
within 24 hours. All applications must be received by midnight on Monday, November 30, 2015. All applicants will be
notified of the decision no later than Monday, December 21, 2015.
Teacher Applicant Information:
Title
Name
Email
Title
School Name
Type of school (public,
private, charter, etc.)
Name / email of
supervisor
School Address
Home Address
Home Phone Number
Teachers: I have read the information about the 2016 Albert H. Small Normandy: Sacrifice for Freedom® Student &
Teacher Institute at http://www.nhd.org/classroom-connection/normandy-sacrifice-for-freedom/. I agree that if
accepted to the Normandy Institute I will make two professional presentations during the 2016-2017 school year and
participate in the National History Day program. I understand that I am responsible for my transportation to and from
Washington, DC and any costs associated with securing or updating a passport.
_________________________________________
(teacher signature)
_________________________________________
(printed name)
TEACHER HEALTH HISTORY
Name: ____________________________
Insurance Company:
Policy/Group #:
________________________________
________________________________
Insurance Company Address:
Insurance Company Phone Number:
________________________________
________________________________
________________________________
Health History: (Please give date where applicable)
1. Surgery (within last year):
2. Medical problems:
3. Emotional problems:
4. Date of last Tetanus Booster:
5. Allergies:
6. Medication(s) teacher is prescribed:
7. Are you under medical treatment at present? Reason?
Please attach additional information if needed.
Student Applicant Information:
Name
Email
Name of school
Grade in 2015-2016
school year
Home address
city, state, zip code
Home phone
Parent / Guardian
name(s)
Parent / Guardian
email(s)
Parent / Guardian phone
number(s)
Students: I agree that if accepted to the Normandy Institute I will participate with my teacher in two professional
presentations during the 2016-2017 school year. I agree to meet all deadlines posted.
_________________________________________
(student signature)
_________________________________________
(printed name)
Parents/Guardians: I have read the information about the 2016 Albert H. Small Normandy: Sacrifice for Freedom®
Student & Teacher Institute at http://www.nhd.org/classroom-connection/normandy-sacrifice-for-freedom/ and I give
my son/daughter permission to apply. I understand that teams are responsible to provide transportation to and from
Washington, DC, and any costs associated with securing or updating a passport.
_________________________________________
(parent/guardian signature)
_________________________________________
(printed name)
_________________________________________
(parent/guardian signature)
_________________________________________
(printed name)
STUDENT HEALTH HISTORY
Name: ____________________________
________________________________
Insurance Company
________________________________
Policy/Group #
Insurance Company Address:
Insurance Company Phone Number:
________________________________
________________________________
________________________________
Health History: (Please give date where applicable and if known)
1. Surgery (within last year):
2. Medical problems:
3. Emotional problems:
4. Date of last Tetanus Booster:
5. Allergies:
6. Medication(s) student is prescribed:
7. Is the student under medical treatment at present? Reason?
Please attach additional information if needed.