Award Nomination Form
Award Nomination Form
| WITEA Awards | |
| WITEA Teacher of the Year | Ken Pattie
Award (25 years of teaching technology) |
| Technology Program of the Year | Outstanding Vendor Award |
| WITEA Tom Staly Service & Leadership Award | |
| ITEA Awards | |||
| ITEA Teacher of the Year | Distinguished Technology Educator | ||
| ITEA Program of the Year | Special Recognition Award | ||
| Nominee Information | |||
| Name of Nominee | Nominated for: (award) | ||
| Nominee's Current Title / School / District |
Subjects
Taught and/or Duties |
||
| WITEA Member? __ yes (required) for ______ years starting in _______ | ITEA Member? __ yes (required) for ______ years starting in _______ | ||
| Describe the outstanding features of the program (Program of the year nomination) or Describe the outstanding qualities of the nominee's teaching (Teacher of the year) |
|||
| Nominee's professional activities and contributions; school and community involvement:
|
|||
| Work Address | City | State | Zip |
| Work Phone | Home Phone | ||
Name and position of individual making nomination:
|
Signature of individual making nomination:
|
||
| Work Address | City | State | Zip |
| Home Address | City | State | Zip |
| Work Phone | Home Phone | ||
|