DTE Energy Foundation Educator of the Year Nomination Form
Nomination Deadline: Friday, January 18, 2019.

Use this form to nominate a candidate for the DTE Energy Foundation Educator of the Year Award.

NOTE: There is no option to save your nomination prior to clicking submit, so please consider drafting your responses in a savable document and cutting/pasting them into the Form when you are ready to submit.

As you complete the nomination form, we encourage you to use clear and specific examples and stories to support your nomination. We are also providing you with our assessment rubric and examples of selection criteria so you will understand how the selection committee will be reviewing your responses.
2018 DTE Energy Foundation Educator of the Year: Denise Allen
Part I-EDUCATOR INFORMATION
1. Educator Nominee Name: *
Your answer
2. Nominee Email: *
Your answer
3. Nominee Phone #: *
Your answer
4. Educator's School: *
Your answer
5. Educator's District *
Your answer
6. Principal of the School: *
Your answer
7. Principal's or School Phone #: *
Your answer
8. Principal's email: *
Your answer
9. Nominator Name: *
Your answer
10. Nominator Phone #: *
Your answer
11.Nominator Email: *
Your answer
12. Describe how the nominated educator has met two or more of the four criteria for award listed (800 words or less): (a) The teacher actively creates a culture of the arts at their school (b) The teacher facilitates arts experiences within the school community. (c) The teacher facilitates arts experiences in other contexts (d) The teacher demonstrates the ability to overcome obstacles. *
Your answer
13. How has the inclusion of the arts as part of the classroom/school culture impacted students and/or the community? (325 words or less) *
Your answer
14. What impact will winning this award have on the educator's career, students, and/or school community? (325 words or less) *
Your answer
15. What is your relationship to the nominee? Please include your community role in your answer (e.g. I am a parent to a child who attends the nominated school, I am the principal of the nominated school, or I am a student etc). *
Your answer
16. Optional: You may submit any additional links or supporting materials here (links to videos, articles, etc).
Your answer
Part II- Recommendations:
Please list the names and contact information of two recommenders. If the recommender is a student under the age of 18, please provide name and contact information for a parent. Recommendations should be short (no more than 5 sentences) and should be submitted via email to Terri Park at tepark@umich.edu no later than Friday, January 18, 2019. Please clearly indicate the name of the nominee in your recommendation.
REFERENCE #1:
a. Name: *
Your answer
b. Parent Name (if recommender is a student): *
Your answer
c. Contact Email: *
Your answer
d. Contact Phone #: *
Your answer
REFERENCE #2
a. Name: *
Your answer
b. Parent Name (if recommender is a student): *
Your answer
c. Contact Email: *
Your answer
d. Contact Phone: *
Your answer
How did you learn about this award? (Check all that apply) *
Required
Download Assessment Rubric: http://bit.ly/2POKaa5
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