2020 NCTE Affiliate Excellence Award Submission Form FOR YOUR RECORDS, PLEASE PRINT ONE COPY OF THIS COMPLETED FORM BEFORE PRESSING THE "DONE" BUTTON. If possible, any supporting documents should be sent electronically by attaching them at the end of this application. The application and all supporting documents should be submitted no later than August 1. If you have any questions, please contact Kirstey Ewald, the selection committee chair, at kewald@centralriversaea.org, Central Rivers Area Education Agency, 1521 Technology Parkway, Cedar Falls, IA 50677.NOTE: You may copy long responses from WORD or another word-processing program and past them into the survey form. Question Title * 1. Complete Name of Affiliate: Question Title * 2. Name of Person Submitting Application: Question Title * 3. Position in Affiliate: Question Title * 4. Email Address: Question Title * 5. Complete Mailing Address: Question Title * 6. If selected would your affiliate be responsible for having a representative on hand to receive the award at the Affiliate Roundtable Breakfast on Sunday morning of the NCTE Annual Convention? (NOTE: The representative is expected to purchase a breakfast ticket with preregistration.) Yes No Comments SECTION IThese activites are REQUIRED for qualification. Please check all that apply and be sure to attach the requested materials. Deadline for submission of application: August 1. Question Title * 7. Please INDICATE if your affiliate has increased its membership through one of the following ways. NOTE: Membership counts are based on membership lists you have submitted to NCTE in the year of the award and the year previous to the award. Increase membership in the affiliate by 5% during a year: 3% if the affiliate has 300 or more members Increase of 5% of NCTE members in the affiliate Maintain current membership AND complete an additional activity from SECTION II Conduct a unique membership campaign designed to increase general affiliate membership as well as to increase the number of members from targeted groups (i.e., minorities, elementary educators, urban/rural/early career teachers). NOTE that the campaign must go beyond the usual means of invitation to join the affiliate and must be conducted in the year of the award. ATTACH a one-page detailed description of the campaign that identifies goals, processes and result AND complete an additional activity in SECTION II. Question Title * 8. If your affiliate conducted a unique membership campaign, please provide a one-page description of that campaign. Question Title * 9. What type of communications instrument does your affiliate publish at least twice a year? Please check all that apply as long as they are published two times each year or more. Newsletter Webpage Journal Letter from President Other (please specify) Question Title * 10. Please submit your supporting documents at the end of this application, if possible, or list what documents you will be mailing. Please complete no later than July 15. Will submit below Will send by US mail First webpage communication URL First webpage communication URL Will submit below First webpage communication URL Will send by US mail Second webpage communication URL Second webpage communication URL Will submit below Second webpage communication URL Will send by US mail First newsletter First newsletter Will submit below First newsletter Will send by US mail Second newsletter Second newsletter Will submit below Second newsletter Will send by US mail First journal First journal Will submit below First journal Will send by US mail Second journal Second journal Will submit below Second journal Will send by US mail First letter from president First letter from president Will submit below First letter from president Will send by US mail Second letter from president Second letter from president Will submit below Second letter from president Will send by US mail First other First other Will submit below First other Will send by US mail Second other Second other Will submit below Second other Will send by US mail Question Title * 11. If you are submitting website messages, please provide the URLs for them below. First website message URL Second website message URL Question Title * 12. If you are submitting letters from your president, please paste these in below with five spaces in between each letter. Please label the letters as needed. Question Title * 13. If you are citing a newsletter, please include the URL of an online issue or the name and issue of the newsletter you'll be sending by US mail in the boxes below. First newsletter Second newsletter Question Title * 14. If you are citing a journal, please include the URL of an online issue or the name and issue of the journal you'll be sending by US mail in the boxes below. First journal Second journal Question Title * 15. Indicate which English language arts professional learning program (s) / event (s) your affiliate has provided for its members. Workshop Conference Study Group Literacy in Learning Exchange Team Other (please specify) Question Title * 16. Please provide a one-paragraph description of the program/event. Question Title * 17. Register for and attend at least TWO affiliate sponsored activities at the NCTE Annual Convention in November. Include a list of participants with each activity attended. Affiliate Roundtable Breakfast Names of Affiliate Members Attending SCOA Sponsored Concurrent Session One Names of Affiliate Members Attending SCOA Sponsored Concurrent Session Two Names of Affiliate Members Attending Affiliate Representatives Meeting Names of Affiliate Members Attending Question Title * 18. Complete the NCTE Annual Affiliate Report Forms by the July 15 deadline for this award. See Annual Affiliate Report Checklist sent to affiliate presidents and liaison officers in April of the year of the award. All forms must be submitted along with a check for the dues and a current membership list, to be eligible for this award. Yes No Other (please specify) Question Title * 19. In addition to the Affiliate Excellence Award, apply to at least ONE other NCTE affiliate awards program. Applied this year. Did not apply this year. Affiliate Multicultural Program Award Affiliate Multicultural Program Award Applied this year. Affiliate Multicultural Program Award Did not apply this year. NCTE Fund Teachers for the Dream Affiliate Award NCTE Fund Teachers for the Dream Affiliate Award Applied this year. NCTE Fund Teachers for the Dream Affiliate Award Did not apply this year. Affiliate Newsletter Award Affiliate Newsletter Award Applied this year. Affiliate Newsletter Award Did not apply this year. Affiliate Journal Award Affiliate Journal Award Applied this year. Affiliate Journal Award Did not apply this year. Affiliate Website Award Affiliate Website Award Applied this year. Affiliate Website Award Did not apply this year. NCTE Leadership Development Award NCTE Leadership Development Award Applied this year. NCTE Leadership Development Award Did not apply this year. NCTE Intellectual Freedom Award (State, Regional, and Provincial) NCTE Intellectual Freedom Award (State, Regional, and Provincial) Applied this year. NCTE Intellectual Freedom Award (State, Regional, and Provincial) Did not apply this year. NCTE High School Teacher of Excellence Award NCTE High School Teacher of Excellence Award Applied this year. NCTE High School Teacher of Excellence Award Did not apply this year. Question Title * 20. Participate with at least ONE delegate in NCTE's Affiliate Leadership Conference. Include names(s) of delegate(s) and date/place of conference below. Name(s) of delegate(s) Date/Place of Conference SECTION IIEach Affiliate applying for the award must complete at least FOUR of the activities listed below IN ADDITION TO THE REQUIRED activities in SECTION I. Please check all that apply and be sure to attach the requested support materials. Question Title * 21. Implement and maintain a plan for affiliate activities that incorporates cultural diversity and inclusion in the language arts profession.Paste in a copy of your plan. If possible, include web links to any supporting materials OR indicate that you will send them by US mail. If possible, please attach copies at the end of this application. Question Title * 22. Publish a second communications instrument IN ADDITION TO the one communications instrument in REQUIRED activity #2 in Section I. If you listed more than one communications instrument in Section I, choose one of those for this question. Please include samples of this additional communications instrument. URL for communications instrument. Name of communications instrument that I will be sending via US mail. Name of second communication instrument already listed in Section I. Question Title * 23. As an affiliate, nominate at least one member of the affiliate for an NCTE office or nominating committee. Name of person nominated Office for which nominated Question Title * 24. Participate in advocacy or policy making activities during the year. Include a brief description of the activity along with any supporting materials. Include if you'll be mailing supporting materials. Question Title * 25. Participate in a project or activity directly involved with curriculum development, either through the affiliate or through local or state education agencies. Include a brief description and include any supporting materials. Indicate if you will be mailing any support materials. You may attach materials below. Question Title * 26. Develop and carry out a program or activity that directly involves members of the local community in English language arts activities. Include a brief description and any supporting materials. Indicate if you will be mailing any supporting materials. You may attach materials below. Question Title * 27. Create an affiliate strategic plan for multiple years that includes an annual budget. Please paste in a copy of the plan and budget. If a strategic plan is already in place, please indicate that and paste in an updated annual budget and a report on progress on goals for the past year. Question Title * 28. Please list all the supporting materials that you will be attaching electronically or sending via US mail. Question Title * 29. Submit support documents. Only PDF, DOC, DOCX, PNG, JPG, JPEG, GIF files are supported. File size limit is 16MB. DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only. Choose File Choose File No file chosen Remove File Only PDF, DOC, DOCX, PNG, JPG, JPEG, GIF files are supported. File size limit is 16MB. Question Title * 30. Submit support documents. Only PDF, DOC, DOCX, PNG, JPG, JPEG, GIF files are supported. File size limit is 16MB. DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only. Choose File Choose File No file chosen Remove File Only PDF, DOC, DOCX, PNG, JPG, JPEG, GIF files are supported. File size limit is 16MB. Question Title * 31. Submit support documents. Only PDF, DOC, DOCX, PNG, JPG, JPEG, GIF files are supported. File size limit is 16MB. DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only. Choose File Choose File No file chosen Remove File Only PDF, DOC, DOCX, PNG, JPG, JPEG, GIF files are supported. File size limit is 16MB. FOR YOUR RECORDS, PLEASE PRINT ONE COPY OF THIS COMPLETED FORM BEFORE PRESSING THE "DONE" BUTTON. If possible, any supporting documents should be sent electronically by attaching them at the end of this application. The application and all supporting documents should be submitted no later than August 1. If you have any questions, please contact Kirstey Ewald, the selection committee chair, at kewald@centralriversaea.org, Central Rivers Area Education Agency, 1521 Technology Parkway, Cedar Falls IA 50677. Done