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Instructions for completing the 2019 National Teacher of the Year Application form:

Please provide all information requested in the application form.

Electronic signatures of the candidate, the candidate's principal, the candidate's district superintendent (chief school administrator), and the State Teacher of the Year Coordinator must be provided.

Please limit your answers to the number of words requested in each section – type size no smaller than 10 point. In order to provide all applicants with an equal opportunity only the number of words requested will be accepted. Any additional pages and/or materials submitted will NOT be presented to the National Selection Committee.

The application package in hard copy must be sent to the Teacher of the Year Coordinator postmarked by Friday, May 25, 2018, to:

Jo Ann BujarskiTeacher of the Year CoordinatorIdaho State Department of EducationPO Box 83720Boise, ID 83720-0027

In addition, an electronic copy of the application, in Microsoft Word format (2007 version or higher), needs to be submitted, prior to or on the May 25, 2018 deadline, to: jbujarski@sde.idaho.gov.

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I. General Information

Preferred Name___________________State _____________________________________ Personal Address Personal Email ___________________Personal Phone Number ______________________School District District Superintendent_________________ District Superintendent Email ___________________School Name ___________________School Principal Name ___________________ Grade Level _________________________School Principal Email ____________________________________School Address ____________________________________School Email ___________________School Phone Number _________________________Subject Area ______________________________________________________________

The National Teacher of the Year Program will correspond with you using your personal email due to security and spam filters on school and district emails. Please be sure it is up to date!

You will also need to attach a headshot (color, portrait orientation, 300ppi, .jpg format).

II Demographic Information

The following information is required, but will have no bearing on your selection. It is collected for informational purposes only and will not be shared with Selection Committee Members. Coordinators will select check boxes of items that apply and will be able to write any options that are not included.

School Size District Size __________________________Years of Teaching Years in Position _________ Twitter_________ AFTHandle Facebook Profile Instragram Profile Personal Blog SitePersonal Web Site Other Social Media What languages other than English do you speak fluently: ____________________________________

Professional Association Memberships (write in all that apply)_________ NEA (including state and local affiliates)_________ AFT (including state and local affiliates)_________ ASCD_________ National Council of Teachers of English_________ National Council of Teachers of Mathematics_________ National Science Teachers Association_________ National Association for Music Education_________ Other (please specify) __________________________

I am a National Board Certified Teacher _________ Yes_________ No_________ In Progress

School Type:_________ Traditional Public_________ Charter Public

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_________ Private _________ Other (please specify) ___________________

School Location: _________ Rural_________ Suburban _________ Urban_________ Other (please specify) ___________________

What is your gender?*_________ Female_________ Male_________ Decline to Answer_________ Other (please specify) ___________________

Which category below includes your age?*_________ 21-29_________ 30-39_________ 40-49_________ 50-59_________ 60 or older

What is your ethnicity?*_________ White (A person having origins in any of the original peoples of Europe, the

Middle East, or North Africa)_________ Black/African American (A person having origins in any of the Black racial groups

of Africa)_________ Native Hawaiian or Other Pacific Islander (A person having origins in any of the

original peoples of Hawaii, Guam, Samoa or other Pacific Islands _________ Asian/Indian Subcontinent (A person having origins in any of the original peoples

of the Far East, Southeast Asia or the Indian Subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand and Vietnam.)

_________ Native American/Alaskan Native (A person having origins in any of the original peoples of North and South America including Central America and who maintains tribal affiliation or community attachment.)

_________ Decline to answer

* The National Teacher of the Year will be selected without regard to race, color, religion, sex or national origin, and will not be discriminated against on the basis of disability.

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III Resume

You will not be able to format this section of your application, so please keep it as simple as possible. Resumes should not exceed two pages. Categories are as follows:

EducationCertificationsExperienceLeadershipAwards and other Recognition

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III Resume

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IV. Professional Biography Please complete your professional biography in the 3rd person, as this will be used in

promotional materials for CCSSO speaking opportunities and engagements. By completing this section, you agree that your biography and headshot can be used in CCSSO materials. (Maximum 250 words)

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V. Response QuestionsRespond to the following questions, highlighting your personal story, and why you believe you should be the 2019 National Teacher of the Year. Please indicate student impact. Please do not include external links. Maximum word counts are indicated in parenthesis.

1. Describe a content lesson or unit that defines you as a teacher. How did you engage students of all backgrounds in the learning? How did that learning influence your students? How are your beliefs about teaching demonstrated in this lesson or unit? (maximum 750 words)

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2. Describe a project or initiative you have been involved in which contributed to the

improvement of overall school culture. What was your role, how did you collaborate with others, and what is the status of this project today? Please include evidence of student impact. (Maximum 500 words)

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3. How do you ensure that education transcends the classroom? Describe specific ways in which you deliberately connect your students and the community. Please include evidence of student impact. (Maximum 500 words)

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4. What do you consider to be a major public education issue today? Describe how you demonstrate being a lifelong learner, and innovator about this issue, both in and outside of the classroom walls. (Maximum 500 words)

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5. As the 2019 National Teacher of the Year, you serve as a spokesperson and

representative for teachers and students. What is your message? What will you communicate to your profession and to the public? (Maximum 750 words)

6. Are you willing to work with the Idaho State Department of Education on messaging?

Yes No Please circle one.

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VI Supporting Evidence

Attach three recommendations that support why you should be the 2019 National Teacher of the Year. At least one of these must be a recommendation from a parent, colleague, administrator, or student and each letter should not exceed one page in length.

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