2010-2011 NAIS Teachers of the Future Nomination Form

1. Call for Nominations for Innovative Teacher Leaders

Please complete this form to nominate a teacher for the 2010-2011 NAIS Teachers of the Future program.

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* 1. Teacher's Name

First Name

Last Name

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* 2. Teacher's School Information

School Name

City

State

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* 3. Teacher's Contact Information

Teacher's Phone

Teacher's E-mail Address

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* 4. Please provide a brief summary about why you are nominating this person.

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* 5. Has the nominee ever moderated other online forums or communities?

Yes

No

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* 6. If yes, what forum(s) or communities?

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* 7. Has the nominee demonstrated teaching excellence in any or all of these areas? (please check all that apply)

Environmentalism

Globalism

Equity and Justice

Technology

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* 8. Innovators often encounter resistance to change as they implement new programs, share new ideas, and develop new paradigms. Please provide a brief description about how the nominee manages resistance to change.

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* 9. Please include links to any online supporting materials or resources (web, audio, video, etc.).

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* 10. If you are nominating another person (not yourself), please provide your contact information.

Nominator's First Name

Nominator's Last Name

Nominator's School

Nominator's E-mail Address

Nominator's Telephone Number