2024 Louisiana Exemplary Educator Recognition Program: Recommendation Form
Please complete and submit this form by EOD on December 15, 2023.
We invite you to recommend exceptional early- to mid-career teachers, teacher specialists, assistant principals and principals who have demonstrated all of the following:
1) Exceptional educational talent as evidenced by effective and innovative instructional practices and student learning results in the classroom and school; 2) Exemplary educational accomplishments and leadership beyond the classroom that provide models of excellence for the profession; 3) Individuals whose contributions to education are largely unheralded yet worthy of the spotlight; 4) Early- to mid-career educators (minimum of five years experience) who offer strong long-range potential for professional and policy leadership; and 5) Engaging and inspiring presence that motivates and impacts students, colleagues and the community.
Recommender's Information
Your Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number (Preferably Cell)
*
Please enter a valid phone number.
Your relation to the candidate
*
Please Select
Supervisor
Colleague
Parent
Other
If "other" was selected, please specify.
How long have you known the candidate? Note- Add the number of the years in the textbox.
*
Back
Next
Candidate's Information
Candidate's Name
*
First Name
Last Name
Candidate's School System
*
Candidate's number of years in the school system
*
Candidate's School Name
*
Candidate's School Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Candidate's Phone Number with Area Code
*
Please enter a valid phone number.
Candidate's Email
*
example@example.com
Candidate's Grade Level(s). Check all that apply for this current school year.
*
PreK
K
1
2
3
4
5
6
7
8
9
10
11
12
The candidate is which of the following:
*
Please Select
Teacher
Specialist
Assistant Principal
Principal
Other
If "other" was selected, please specify.
If candidate is a teacher, please select subject area. (Check all that apply for the current school year.)
*
Reading/English Language Arts
Science
Mathematics
Social Studies
Fine Arts
Foreign Language
Other
If "foreign language" or "other" was selected, please specify.
Candidate's Ethnicity
*
Please Select
White
Asian
Hispanic or Latino
Black or African American
Native American Indian or Alaska Native
Native Hawaiian or Other Pacific Islander
Two or More Races
Prefer Not to Answer
Candidate's Education Information
List the College/University Where the Candidate Got Their Degree(s) as well as the Year the Degree was Obtained. View that information here- https://www.teachlouisiana.net/teachers.aspx?PageID=416
Bachelor's
*
Year Obtained
*
Master's
Year Obtained
Specialist
Year Obtained
Doctorate
Year Obtained
List where the teacher completed their teacher preparation program.
*
Back
Next
References
As a part of the application review process for the Exemplary Educator Award, reference checks may be completed for nominated candidates. As a nominator, you are already serving as a reference for your nominee. Using the form below, please list three (3) additional points of contact who can serve as professional references for the candidate in support of their candidacy. Note: 1) References should be individuals who have recent experience working directly with the nominee in a professional capacity; and 2) If you are not the direct supervisor of the candidate you are nominating, please ensure that the nominee's direct supervisor is listed as one of the three references below.
Reference One
Prefix
*
Please Select
Dr.
Mr.
Mrs.
Ms.
Miss
Prefer Not to Answer
Name
*
First Name
Last Name
Title
*
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Reference Two
Prefix
*
Please Select
Dr.
Mr.
Mrs.
Ms.
Miss
Prefer Not to Answer
Name
*
First Name
Last Name
Title
*
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Reference Three
Prefix
*
Please Select
Dr.
Mr.
Mrs.
Ms.
Miss
Prefer Not to Answer
Name
*
First Name
Last Name
Title
*
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Back
Next
Ratings and Responses from the Exemplary Educator Recommendation Form
Rate the educator from 1-10 (10 being highest) on numbers 1 through 4 and provide a paragraph(s) to explain your rating. Be detailed and thorough, with examples whenever possible.
1. Exceptional educational talent as evidenced by effective instructional and innovative practices and student learning results in the classroom and school.
Rating for Response 1
*
Please Select
1
2
3
4
5
6
7
8
9
10
Explanation of Rating for Response 1
*
2. Exemplary educational accomplishments and leadership beyond the classroom that provide models of excellence for the profession. Include committees, mentoring, news items, publications, and presentations.
Rating for Response 2
*
Please Select
1
2
3
4
5
6
7
8
9
10
Explanation of Rating for Response 2
*
3. Strong long-range potential for professional and policy leadership including teacher leadership and 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.
Rating for Response 3
*
Please Select
1
2
3
4
5
6
7
8
9
10
Explanation of Rating for Response 3
*
4. 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.?
Rating for Response 4
*
Please Select
1
2
3
4
5
6
7
8
9
10
Explanation of Rating for Response 4
*
Back
Next
Achievements/Awards
Copy and paste from the Exemplary Educator Recommendation Form.
Cite evidence of student achievement gains as a result of the educator’s practices, even if from a previous year.
*
Cite awards the educator has received.
*
Back
Next
Uploads
Upload the Candidate's Resume (Note- Do not ask the candidate for their resume, as this is a confidential recommendation. You may create a simple resume as a bulleted list of employment history.)
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Upload Letter of Recommendation (Optional) If you or someone else would like to include a letter of support for this candidate, please upload here as a word document or PDF.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Has the school system superintendent or CEO approved this recommendation? Note- All recommendations will be shared with the school system to review and indicate approval to move the candidate forward with consideration for the award.
Please Select
Yes
No
Submit
Should be Empty: