MO-CASE Outstanding New Special Education Administrator Award Nomination Form
To be completed by the person nominating the individual:
Indivdiual who is making the nomination *
Your answer
Email for individual making the nomination *
Your answer
Nominee's Name *
Your answer
Nominee's Address *
Your answer
City, State, Zip *
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Nominee's Phone *
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Nominee's Email *
Your answer
Is the nominee a CEC Member? *
Required
Is the nominee a CASE Member? *
Please list the candidates CEC, CASE, and MO-CASE Membership Number (it is the same number for all of these memberships).
Your answer
What is the nominee's current position? *
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How long has the individual been in their current position? *
Your answer
Please provide information regarding the nominee's prior experience and activities:
Number of years this individual has been in education. *
Your answer
Demonstrates Leadership - Including proficiency in current practice, supports study and research guided by the conventions of scholarly inquire, fosters and supports self-determination and independence on the part of exceptional children, provides meaningful professional development opportunities for colleagues and the public, and upholds and advances the values, ethics, knowledge and mission of the profession. (0-10 points, include 300-600 words) *
Your answer
Innovation and Contributions to Special Education and/or Quality of Services to Children with Exceptionalities - Describe innovative and effective programs the nominee has led and indicate how those programs have positively influenced special education programming and services to exceptional children in her/his school, district, and/or region. (0-10 points; 300 - 600 words) *
Your answer
Additional Education-Related and/or Community Accomplishments and Recognitions - Provide any additional information which would support citing the career of the nominee, but which does not relate directly to the previous sections. Other honors or awards (with dates) may be noted. (0-5 points; 300 - 600 words) *
Your answer
Additional Information Required
Email the following information to Carrie Turner at cturner@gvr5.net and note it is connected to the nominee for this award.

Must also include a resume/vita for the nominee, and a minimum of one (maximum of three) letter(s) of recommendation.

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