2018 CLMS Educator of the Year Nomination Form
General Nomination Deadline: October 15, 2017
Region 1 Deadline: October 28, 2017
Region 3 Deadline: October 20, 2017
Region 4 Deadline; November 3, 2017
Region 5 Deadline: October 9, 2017
Region 7 Deadline, October 20, 2017
Region 8 Deadline: November 1, 2017
Region 10 Deadline: November 1, 2017


If you have any questions about the regional selection process, please contact the CLMS Board Member in your region to inquire
http://www.leagueofschools.org/about/clsboard.htm

Nominee
Your answer
Nominee's Email
Your answer
Nominee's Position
Your answer
Nominee's School
Your answer
Years in Education
Your answer
Years in Position
Your answer
Region
(please indicate the county in which the nominee works):
Principal
Your answer
School Address
Your answer
School City
Your answer
School State
Your answer
School Zip
Your answer
School Phone
Your answer
School Fax
Your answer
School District
Your answer
Superintendent
Your answer
District Address
Your answer
District City
Your answer
District State
Your answer
District Zip
Your answer
District Phone
Your answer
Nominator's Information
Nominator's Name
Your answer
Nominator's Position
Your answer
Nominator's Email
Your answer
Nominator's School/District
Your answer
Nominator's Address
Your answer
Nominator's City
Your answer
Nominator's State
Your answer
Nominator's Zip
Your answer
Nominator's Phone
Your answer
Nominator's Cell
Only used if we need to contact you regarding this form.
Your answer
Tell us more about your nominee
Criteria (The following characteristics will be considered in judging nomination.)

Leadership Characteristics: Dedicated; innovative; exhibits professional collegiality; enthusiastic; proactive

Middle School Awareness: Supportive of middle school movement; demonstrates middle school concepts; committed to and uses principles of Caught in the Middle, Turning Points, Taking Center Stage and/or other middle school documents; incorporates State Frameworks and Standards

Exemplary Characteristics: Demonstrates beyond the job responsibilities; acts as role model; demonstrates ability to motivate students from diverse backgrounds; other unique abilities and/or contributions Instructions

Please incorporate responses to the following in your narrative: Describe how the nominee meets or exceeds the above criteria; Tell how the nominee has demonstrated leadership in implementing or supporting educational reform and improved student achievement.

Narrative
PLEASE: type your narrative into a word processor and SAVE it. Then copy and paste the text into the box below. Box will expand to fit approximately 800 words.
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms