2018 CLHS Educator of the Year Nomination Form
General Nomination Deadline: October 15, 2017
Region 4 Deadline: November 3, 2017
Region 7 Deadline: October 20, 2017
Region 8 Deadline: November 1, 2017
Region 10 Deadline: October 31, 2017


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

Nominee's Information
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 rubric used to evaluate the nominees contains the following stated criteria.
Give SPECIFIC EXAMPLES to show how the nominee meets these criteria.
(The following characteristics will be considered in evaluating nominations.)

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

High School Change Agent: Knowledgeable advocate of high school reform in accordance with current educational trends and practices; shares knowledge with colleagues; incorporates State Frameworks and Standards, current research, and technology.

Exemplary Characteristics: Demonstrates/supports powerful teaching and learning; demonstrates beyond the job responsibilities; acts as a 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 and give specific examples to show how the nominee meets or exceed the above criteria.

Tell how the nominee supports the practices and concepts outlined in the criteria above and demonstrates leadership in implementing educational reform and improving 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
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