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Innovative Teachers Leadership Award (ITLA) 2012
ITLA 2012
Note : Please follow the Instructions as specified in the ITLA 2011-12 - template guideline.doc file, available in the Teacher’s Competition folder to complete this template
Index
1. Section – A
• Applicant’s profile
2. Section - B
3. Section – C – Letters of Support
a. Professional Reflections
b. Teacher’s PPT
c. Community Work
a. Administrator/ Principal/ Regional Co- ordinator
b. Parent or Community Member
c. Colleague
Section APersonal Profile
Registration Segment (Public / Private School, Government School, Special Category*)
Name of the Teacher
Date of Birth (MM/DD/YY) :
Address for Communication
House No. Street
Town District
State PIN code
Email Id : (live or hotmail )
Personal Contact No.
Landline with STD Code Mobile
Mobile
School Name and Address
Languages familiar with
Teaching Focus e.g. Maths, Science, Social Studies etc.
Classes Taught
I access my PC at: (Home/ School/ i-café/Do not access)
Do you have a Passport? (Yes/No)
If YES, Passport No.
Expiry Date
I would like to receive communication from Microsoft on such events and other activities: (Yes/No)
Section B
a. Professional ReflectionsDouble Click on the Icon below to write about your
professional Reflections.
Professional Reflection
Section-B
Teacher’s PPT. (Best Lesson plan)
Name of the presentation submitted for the contest
Class or age group(ppt. meant for which class or age group)
Objective
After inserting the object (refer guidelines) Resize and place your embedded Ppt. here (you will see the first slide of your lesson plan)
Section-B
List of Teacher’s work (other than the one submitted as ITLA 2011 - 12 contest entry):
S.No Name of the Lesson Plan Target Class
No. of Students Covered
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Section-B
Community Work – Screenshot 1 (scanned document)
A brief synopsis of the screen shot ( in 1 or 2 lines):
Section-B
Community Work – Screenshot 2 (scanned document)
A brief synopsis of the screen shot ( in 1 or 2 lines):
Section-B
A brief synopsis of the screen shot ( in 1 or 2 lines):
Section-B
Community Work – Screenshot 3 (scanned document)
List of other work done towards community (Do not repeat the scanned items):
S.No Name of the Community Work
Beneficiaries & remarks
Section-B
Section CLetters of Support
Letter of Support (Scanned copy) Administrator/ Principal/ Regional Co- ordinator
Section-C
Letter of Support (Scanned copy) : Parent or Community Member
Section-C
Letter of Support (Scanned copy) : Colleague
Section-C
Message from the Teacher:
Acknowledgement