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1. ND TOY 2010 Application Form

North Dakota Teacher of the Year 2010 Application Form
DEPARTMENT OF PUBLIC INSTRUCTION
STANDARDS AND ACHIEVEMENT


I. General Information/Signatures

1. Nominee

Number of Students in Nominee's District/Building

2. Students

Major Subject Area (if any)/Grade Level

3. Subject

4. Grade

Total Years of Teaching Experience

5. Experience

Years in Present Position

6. Years

I hereby give my permission that any or all of the attached materials (other than home address, telephone, SS# and DOB) may be shared with persons interested in promoting the State/National Teacher of the Year Program. I also acknowledge that if selected as the National Teacher of the Year 2010, I will be released from classroom responsibilities during the year of my recognition in order to fulfill the obligations inherent in the honor.
Signature of Candidate/Date

7. Signature

8. Date

School/Building Principal

9. Principal

I acknowledge that the nominee submits this application with my approval. If the nominee is selected as the 2010 National Teacher of the Year, he or she will be released from classroom responsibilities during the year of recognition.
Signature of School Principal/Date

10. Signature

11. Date

School Superintendent

12. Superintendent

I acknowledge that the nominee submits this application with my approval. If the nominee is selected as the 2010 National Teacher of the Year, he or she will be released from classroom responsibilities during the year of recognition.
Signature of Superintendent/Date

13. Signature

14. Date

II. Educational History and Professional Development Activities -- (two double-spaced pages)
A. Beginning with most recent, list colleges and universities attended including postgraduate studies. Indicate degrees earned and dates of attendance.
B. Beginning with most recent, list teaching employment history indicating time period, grade level and subject area.
C. Beginning with most recent, list professional association memberships including information regarding offices held and other relevant activities.
D. Beginning with most recent, list staff development leadership activity and leadership activity in the training of future teachers.
E. Beginning with the most recent, list awards and other recognition of your teaching.

15. History (Paragraph 1)

16. History (Paragraph 2)

17. History (Paragraph 3)

18. History (Paragraph 4)

19. History (Paragraph 5)

20. History (Paragraph 6)

III. Professional Biography -- (two double-spaced pages)
A. What were the factors that influenced you to become a teacher? Describe what you consider to be your greatest contributions and accomplishments in education.

21. Biography (Paragraph 1)

22. Biography (Paragraph 2)

23. Biography (Paragraph 3)

24. Biography (Paragraph 4)

25. Biography (Paragraph 5)

26. Biography (Paragraph 6)

IV. Community Involvement -- (one double-spaced page)
A. Describe your commitment to your community through service-oriented activities such as volunteer work, civic responsibilities, and other group activities.

27. Involvement (Paragraph 1)

28. Involvement (Paragraph 2)

29. Involvement (Paragraph 3)

V. Philosophy of Teaching -- (two double-spaced pages)
A. Describe your personal feelings and beliefs about teaching, including your own ideas of what makes you an outstanding teacher. Describe rewards you find in teaching.
B. How are your beliefs about teaching demonstrated in your personal teaching style?

30. Philosophy (Paragraph 1)

31. Philosophy (Paragraph 2)

32. Philosophy (Paragraph 3)

33. Philosophy (Paragraph 4)

34. Philosophy (Paragraph 5)

35. Philosophy (Paragraph 6)

VI. Education Issues and Trends -- (two double-spaced pages)
A. What do you consider to be the major public education issues today? Address one in depth, outlining possible causes, effects and resolutions.

36. Issues/Trends (Paragraph 1)

37. Issues/Trends (Paragraph 2)

38. Issues/Trends (Paragraph 3)

39. Issues/Trends (Paragraph 4)

40. Issues/Trends (Paragraph 5)

41. Issues/Trends (Paragraph 6)

VII. The Teaching Profession -- (two double-spaced pages)
A. What do you do to strengthen and improve the teaching profession?
B. What is and/or what should be the basis for accountability in the teaching profession?

42. Teaching (Paragraph 1)

43. Teaching (Paragraph 2)

44. Teaching (Paragraph 3)

45. Teaching (Paragraph 4)

46. Teaching (Paragraph 5)

47. Teaching (Paragraph 6)

VIII. National Teacher of the Year -- (one double-spaced page)
A. As the 2010 National Teacher of the Year, you would serve as a spokesperson and representative for the entire teaching profession. What would be your message? What would you communicate to your profession and to the general public?

48. National Teacher (Paragraph 1)

49. National Teacher (Paragraph 2)

50. National Teacher (Paragraph 3)

IX. Letters of Support -- (Limit of three letters, each a MAXIMUM of ONE PAGE)
Mail three letters of support from any of the following: superintendent, principal, administrator, colleague, student/former student, parent, or civic leader to:

ND Department of Public Instruction
Talent Pool Program Administrator
600 E. Boulevard Ave., Dept. 201
Bismarck, ND 58505-0440
Submit TOY application and letters of support no later than the close of business on Tuesday, July 1, 2009

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