Wednesday, February 22, 2012
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NOMINATION FORM
for
Ed Leader Awards and Fellowships, 2011-12
Feel free to nominate yourself/others
Are you nominating yourself?
Yes
No, Somebody Else
Name
*
:
Designation
*
:
School
*
:
Address
*
:
There are three categories in which applicants may nominate themselves or others.
You are applying for (please tick any one box) :
Category A : Education Innovator Award -
an innovation you are proud of being a part of
Category B : Innovation In-Process Fellowship -
An innovation you would like to do/ undertake
Category C : Outstanding Contribution to Education Award -
You or someone you know has made a lifelong or outstanding
contribution to education that deserves highest recognition.
For Category A and B (For Category C, please do not fill this section. Move to category C).
The Following points may be taken into consideration while nominating a person/team:
1.
Any innovative idea you or your colleague(s) have or are implementing in your class or school / policy regime / NGO
2.
Exact area of innovation / implementation
3.
Target group
4.
Specific interventions
5.
Time frames (when begun or intended to begin and end)
6.
List your team members
7.
Briefly outline how you will implement your programme (you may use extra power, if required).
8.
Any other reasons why your programme/idea is innovative beyond what others do?
9.
Can your idea be replicated/scaled up by others? How and what is involved in replicating / scaling up?
For those who have already implemented their innovative ideas :
10.
Description of impact, what difference has it made and to whom?
11.
How was the impact measured?
12.
Describe what data you have collected from both control and treatment groups to measure impact (treatment group is the group which is undergoing your innovation, control group is a similar age/class/cohort that is not undergoing your innovative programme but against which you can compare your data and therefore measure/ proxy for theimpact of your programe).
13.
Progress : Are you documenting your programme by using evidence from both control and treatment groups before and after the programme using data and documentation through :
photographs
YES /
NO
performance tasks
YES /
NO
video logs
YES /
NO
rubrics or guiding descriptors
YES /
NO
Writing samples
YES /
NO
portfolios of work
YES /
NO
structure observations
YES /
NO
benchmarks and continuums
YES /
NO
anecdotal records
YES /
NO
student/teacher/parent conferences
YES /
NO
Explain:
14.
Is the process still ongoing and will it continue into the future? Explain.
15.
Describe any difficulties faced by you/your team in the process of implementation and how they were overcome?
16.
What inspired you/your team to bring about change?
17.
What is the research basis to show that this experiment/innovation is more powerful than the traditional or commonly used methods?
Innovations Galore! Some keywords for your innovative Endeavors in Education....
•
Teacher as a Scientist/Researcher
•
Catalytic Change
•
Classroom Structures/Mixed Ages
•
Widespread Impact
•
Special Education
•
Timetabling/Scheduling
•
Content Development
•
Alternative Teaching Methods
•
Technology Integration
•
Systematic Change
•
Innovative/New Policy Change/Direction
•
Innovative Assessments and Reporting
For Category C
Outstanding Contribution to Education Award
BACKGROUND DATA
1.
Is the nominee a :
Decision Maker
Practitioner
Team
2.
Name(s) of the Nominee (can be self) :
Date of Birth:
3.
Present Position (exact title) :
Tel. No.
(
)
Mobile No.
Fax No.
(
)
Institution:
Email:
Address:
4.
Describe in which ways the nominee /you have made an outstanding contribution to education?
5.
Period over which you/nominee was involved in making this outstanding contribution Please give dates and details.
6.
How is your/nominee's contribution different from others who are also making an outstanding contribution in education?
7.
How do you know this person (if you are not nominating yourself)?
8.
Curriculum Vitae
Please attach a copy of your/your nominee's Curriculum Vitae which includes qualifications, work and/or research experience and other relevant information.
(Please attach any other supporting documentation. List all that is attached.)
Attachment-1
Attachment-2
Attachment-3
Attachment-4
Please Note: Nominations are accepted for people from all countries and cultures.
*Please be prepared to showcase/ share your innovative idea at the IV Ed Leadership International Roundtable. Please fill, sign and sent no later than 1st of August, 2011
