Www.campbellsville.edu



SUPERINTENDENT’S CONFIRMATION FORMSuperintendent ___________________________________________________________Phone __________________________________________________________________School District ___________________________________________________________Mailing Address __________________________________________________________ __________________________________________________________Superintendent’s Email Address ____________________________________________Signature of Superintendent _________________________________________________ Please return the following information by February 26, 2021Superintendent’s Confirmation Form, page 2Listing of Award Recipients, page 3Biographical Data Sheets (elementary, middle school, high school), pages 4-6FormsYou may also find the forms at campbellsville.eduGo to Academics at the top of the page and then Schools and Colleges, School of Education.Excellence in Teaching will be on the left-hand side of the page in a bold black font.Instructions for Returning FormsBy mail:School of EducationExcellence in TeachingCampbellsville University UPO 7971 University DriveCampbellsville, KY 42718-2190By email: To Alice Steele at absteele@campbellsville.eduQuestionsYou may contact:Elizabeth Franklin, 270.789.5252, emfranklin@campbellsville.eduAlice Steele, 270.789.5160, absteele@campbellsville.edu2LISTING OF AWARD RECIPIENTSPRESCHOOL/ELEMENTARY GRADES AWARD RECIPIENTName ___________________________________________________ Phone ____________________________ TitleFirstMiddleLastHome Mailing Address _______________________________________________________________________Name & Address of School _____________________________________________________________________________________________________________________________________________________________Subject/Grade Level Taught___________________________________________________________________Recipient’s Email Address ____________________________________________________________________Name of Principal ___________________________________________________________________________Principal’s Email Address_____________________________________________________________________MIDDLE GRADES AWARD RECIPIENTName ___________________________________________________ Phone ____________________________ TitleFirstMiddleLastHome Mailing Address _______________________________________________________________________Name & Address of School _____________________________________________________________________________________________________________________________________________________________Subject/Grade Level Taught ___________________________________________________________________Recipient’s Email Address ____________________________________________________________________Name of Principal ___________________________________________________________________________Principal’s Email Address ____________________________________________________________________HIGH SCHOOL AWARD RECIPIENT Name ___________________________________________________ Phone ____________________________ TitleFirstMiddleLastHome Mailing Address _______________________________________________________________________Name & Address of School _____________________________________________________________________________________________________________________________________________________________Subject/Grade Level Taught ___________________________________________________________________Recipient’s Email Address ____________________________________________________________________Name of Principal ___________________________________________________________________________Principal’s Email Address ____________________________________________________________________3EIT Biographical Data Sheet: Preschool/Elementary School Award RecipientDirections: Complete and return this form to your superintendent’s office. Name ______________________________________________________________________________________________TitleFirst Middle(Maiden) LastAddress ___________________________________________________________________________________________CityState ZipTelephone ______________________ Email address ______________________________________________________Spouse __________________________________________ (Maiden name of spouse, if applicable) _________________Children 1. _________________________________ 2. ______________________________ 3. _________________________________ 4. ______________________________ (optional information)Parents: Mother _____________________________________________________________________________________NameAddressCity, State Father _____________________________________________________________________________________NameAddressCity, StateEDUCATIONHigh School (Name) __________________________ (City, State) __________________________Year Graduated _____College/University __________________________________Degree*_____________ Year Graduated________________College/University __________________________________Degree*_____________ Year Graduated ________________Other _____________________________________________________________________________*Please indicate specific degree: i.e. M.A., B.A., B.S., etc.PROFESSIONAL POSITIONS HELDName of School_______________________________________ District ___________________________________ Subject/grade level _____________________________________ Date of employment ________________________Name of School ________________________________________ District __________________________________ Subject/grade level _____________________________________ Date of employment ________________________Other _________________________________________________________________________________________404025788431 YES NO00 YES NOI am currently or have been a cooperating teacher for a CU student teacher. ____ ____337726198425 YES NO00 YES NOIf NO, are you interested in becoming a cooperating teacher? ____ ____MEDIA: WHERE WOULD YOU LIKE US TO SEND YOUR PHOTO ___________________________________________________________________________________________NameEmail Address ___________________________________________________________________________________________NameEmail Address4EIT Biographical Data Sheet: Middle School Award RecipientDirections: Complete and return this form to your superintendent’s office. Name _________________________________________________________________________________________TitleFirst Middle(Maiden) LastAddress _______________________________________________________________________________________CityState ZipTelephone ______________________ Email address _________________________________________________Spouse __________________________________________ (Maiden name of spouse, if applicable) ____________Children 1. _________________________________ 2. ______________________________ 3. _________________________________ 4. ______________________________ (optional information)Parents: Mother ________________________________________________________________________________NameAddressCity, State Father ________________________________________________________________________________NameAddressCity, StateEDUCATIONHigh School (Name) ____________________________ (City, State) _________________________Year Graduated ____College/University __________________________________Degree*_____________ Year Graduated_______________College/University __________________________________Degree*_____________ Year Graduated _______________ Other ____________________________________________________________________________*Please indicate specific degree: i.e. M.A., B.A., B.S., etc.PROFESSIONAL POSITIONS HELDName of School ________________________________________District _______________________________ Subject/grade level _____________________________________Date of Employment _____________________Name of School ________________________________________District _______________________________Subject/grade level _____________________________________Date of Employment _____________________Other ______________________________________________________________________________________421733988265 YES NO00 YES NO I am currently or have been a cooperating teacher for a CU student teacher. ____ ____353728198425 YES NO00 YES NO If NO, are you interested in becoming a cooperating teacher? ____ ____MEDIA: WHERE WOULD YOU LIKE US TO SEND YOUR PHOTO ___________________________________________________________________________________________NameEmail Address ___________________________________________________________________________________________NameEmail Address5EIT Biographical Data Sheet: High School Award RecipientDirections: Complete and return this form to your superintendent’s office. Name _________________________________________________________________________________________TitleFirst Middle(Maiden) LastAddress ________________________________________________________________________________________CityState ZipTelephone ______________________ Email address __________________________________________________Spouse __________________________________________ (Maiden name of spouse, if applicable) ____________Children 1. _________________________________ 2. ______________________________ 3. _________________________________ 4. ______________________________ (optional information)Parents: Mother ________________________________________________________________________________NameAddressCity, State Father ________________________________________________________________________________NameAddressCity, StateEDUCATIONHigh School (Name) ________________________ (City, State) __________________________Year Graduated ______College/University __________________________________Degree*_____________ Year Graduated_______________College/University __________________________________Degree*_____________ Year Graduated _______________ Other ____________________________________________________________________________*Please indicate specific degree: i.e. M.A., B.A., B.S., etc.PROFESSIONAL POSITIONS HELDName of school________________________________________ District _______________________________ Subject/grade level _____________________________________ Date of employment _____________________Name of school ________________________________________ District _______________________________Subject/grade level _____________________________________ Date of employment _____________________Other ______________________________________________________________________________________421733988265 YES NO00 YES NO I am currently or have been a cooperating teacher for a CU student teacher. ____ ____353728198425 YES NO00 YES NO If NO, are you interested in becoming a cooperating teacher? ____ ____MEDIA: WHERE WOULD YOU LIKE US TO SEND YOUR PHOTO ___________________________________________________________________________________________NameEmail address ___________________________________________________________________________________________NameEmail address 6What is the purpose of the excellence in teaching award?The purpose of this award is to recognize the quality teaching in the schools of the state of Kentucky and to strengthen the field of education. It provides statewide recognition to three outstanding individuals from your school district for their leadership and dedication to the teaching profession. Implicit in the award is the expectation that the recipients' examples may inspire all teachers to excel.How many teachers do we select?You may select the following teachers to honor from your district: One preschool OR one elementary teacherOne middle school teacherOne high school teacherYou do not have to nominate someone from each level. You may not, however, choose two teachers from the same category. Recipients of the 2020 award are ineligible for the 2021 award.What do the award recipients receive?In addition to recognition and an awards ceremony, recipients will receive a personalized certificate. A press release and photo will be sent to the newspaper in the recipient’s community, if desired.Reservations will be required to attend the luncheon.Who chooses the award recipients?The process for selection is decided by the district. One way to make the selection is to form a committee consisting of the PTSO chair, principals, instructional supervisors, superintendent, and/or faculty members.What is the deadline for the 2021 selections?Submissions for the award must be received in the School of Education office no later thanFebruary 26, 2021.Use the Superintendent’s Confirmation Form, page 2. This form should originate from the superintendent’s office and be signed by the superintendent.What are the criteria for selecting the recipients?1) Applies energy and enthusiasm to teaching2) Uses a variety of methods of effective instruction3) Applies imagination and originality in meeting students’ needs4) Demonstrates efficient scheduling of time, thoroughness in handling assignments, and reliability5) Exhibits professional integrity and ability to cooperate6) Devotes time and energy to improving professional competence7) Helps others to gain professional competence8) Works to maintain a strong working relationship between the school and community9) Demonstrates good moral character ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download