Distinguished Educators Recognition

Distinguished Educators Recognition
This is a confidential process. Individuals should not be aware of this recommendation.
Name of Recommended Educator:*
Role in Education:*
Specify Role if "Other" was Indicated:
For Teachers, grade(s) currently teaching:
For Principals, grade levels in building:
Subject Area(s)

Reading/English/Language ArtsSocial StudiesForeign LanguageScienceFine ArtsMathematics
Total Years in Education:
For Principals, number of years as an administrator:
Will this person be at the same school next year?

YesNo
School District:*
School Name: *
School Address:
School Phone Number:
School Fax Number:
Educator's Supervisor: *
Supervisor's Phone Number:
Supervisor's Email:
Today's Date*

MonthDayYear
RATE educator from 1-10 (10 being highest) on the following four criteria and provide a paragraph to explain your rating. Be as detailed and thorough as possbile, with examples whenever possible.

	10	9	8	7	6	5	4	3	2	1
Exceptional educational talent as evidenced by effective instructional and innovative practices and student learning results in the classroom and school.

	10	9	8	7	6	5	4	3	2	1
Exemplary educational accomplishments and leadership beyond the classroom that provide models of excellence for the profession. Include committees, mentoring, news items, publications, presentations.

	10	9	8	7	6	5	4	3	2	1
Strong long-range potential for professional and policy leadership including teacher leadership, mentoring. Predict the educator's potential to remain in education for at least 25 more years and demonstrate and increase leadership impact in the profession.

	10	9	8	7	6	5	4	3	2	1
Engaging and inspiring presence that motivates and impacts students, colleagues and the community. Do students perform at higher levels due to the educator, pursue certain careers, credit their success to the educator, etc.?

Explain your rating from above. *
Cite any Evidence of student achievement gains as a result of the educator's practices:
Cite any awards the educator has received:
Other Comments:
If Known, Please Indicate Schools Attended, Degrees, Graduation Years:
Indicate ethnicity of educator being recommended:

AsianBlack or African AmericanHispanic or LatinoNative American Indiana or Alaska NativeNative Hawaiian or Other Pacific IslanderWhite
Please list the names and phone numbers of three professional references other than you for the educator. We may call and talk to them. They should know the educator currently and very well. *
*
*
Please list your Name, Title, Phone Number, and Email Address: *
Should be Empty: