NAME: ____________________________ GRADE/SUBJECT:___________________

REGION:_________________________________ SCHOOL:_________________________________

SUE LEHMANN AWARD FOR EXCELLENCE IN TEACHING

Regional Nomination Form
Thank you for taking time to fill out this questionnaire. Your answers not only help us select national nominees for the Sue Lehmann Award from among many deserving candidates, but they also help us learn more about how effective corps members operate, which in turn helps us design training and support programs for future corps members. This form is due (in soft copy) to Joaquin Hernandez (joaquintfa@gmail.com) along with the materials listed below by Thursday, March 1st COB: Vision/Big Goal(s) Updated Tracker(s) Unit Plan, Unit Assessment, and a sample Lesson Plan from the same unit Long-Term Plan (e.g., a list of standards you've planned to cover each month)

PLEASE BE AS SPECIFIC AS POSSIBLE:

1. Please describe in your own words what -- during the 2010-2011 school year -- you were
trying to accomplish with your students (i.e., your full vision) and also what specifically your classs Big Goal was. 2. By the end of the year, how successful was your class at reaching your vision and attaining the big goal that you set forth? How did you know (i.e., what evidence did you draw upon)?

3. Similar to question 1, how would you describe what you are trying to accomplish with your
students this year? What is your classs Big Goal this year?

4. As of now, how successful are your students at reaching your vision and attaining the big
goal? What evidence are you drawing upon in making this appraisal? 5. What aspects of the Teaching As Leadership approach do you feel are best reflected in your practice? (e.g., setting big goals, investing students and influencers, planning purposefully, executing effectively, continually increasing effectiveness, working relentlessly) Please share a few examples.

6. What is the biggest challenge you have faced in your work towards realizing your vision
with your students? How have you approached that challenge? What happened? 7. Looking back on the past 1.5 years in the classroom, what have been your key learnings about both your leadership in this movement as well as the leadership necessary to continue on our path?