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2013 Teacher of the Year Nomination Form
This form, or a photocopy, must be used to submit nominations. It takes the place of any resume or vitae. A criteria explanation is required (two pages maximum). Also attach two letters of support, one page each. Nominations must be submitted to the Shasta County Office of Education - Instructional Services Department.
Criteria
A nominee for Teacher of the Year must be an active teacher in public or private school who demonstrates exemplary performance in the following standards. Attach two pages maximum explaining how your nominee meets these criteria, providing specific examples. These two pages are in addition to your two pages of supporting documents.
1. Commitment to the success of all students
2. Commitment to working with grade level/department colleagues to improve instruction
3. Commitment to professional growth – a desire for continuous improvement
4. Commitment to continuous improvement in instruction
5. Commitment to using data to close the achievement gap
6. Commitment to school community involvement
7. Creativity and innovation in dealing with issues and problems facing today’s teachers
Award Nominee
|Name of Nominee | |Grade | |Subject | |
| | | | | |
|School | |District | |
| | | | | |
|School Address | |City | | Zip | |
| | | | | |
|School Phone | |Home Phone | |
| | | | | |
|Cell Phone | |Email | |
| | | | |
|Home Address | | | |
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| | | | |
| | | | | |
|Nominee Signature | | |Date |
Nominated By
|Name | |Title | |
| | | | |
|Contact Phone | |Contact Email | |
Professional Growth
Please select no more than four major activities in each category, keeping your responses to this page.
A. Nominee’s Educational Experience:
Position Held School / Districts Dates
|1. | | | | | |
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|2. | | | | | |
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|3. | | | | | |
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|4. | | | | | |
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B. Memberships/Offices Held In Professional Organizations/Dates:
|1. | |
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|2. | |
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|3. | |
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|4. | |
C. Awards/Recognitions/Publications/Articles/Presentations/Dates:
|1. | |
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|2. | |
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|3. | |
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|4. | |
D. School or Community Leadership Involvement:
|1. | |
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|2. | |
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|3. | |
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|4. | |
E. Other:
|1. | |
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|2. | |
| Before you submit your nomination, be sure to include: |
| |Your completed typed nomination form. |
| |Two pages, maximum, explaining how the nominee meets the award criteria. |
| |Two letters of support, one page each. |
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Shasta County Office of Education
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