Gary Dickinson Award for Teaching Excellence

Nomination Form


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Teacher Data

Teacher's Last Name:
First Name:
Middle Name:
School Name:
Street Address of school:
City:
State/Province:
Zip+4/Postal Code:
Phone (home):
Phone (school):
Fax:
Email:

Principal Data

Principal's Last Name:
First Name:
Middle Name:
Phone:
Fax:
Email:

Superintendent Data

Superintendent Last Name:
First Name:
Middle Name:
Name of School District:
Street Address of Office:
City:
State/Province:
Zip+4/Postal Code:
Phone:
Fax:
Email:

Nominator Data

Nominator's Last Name:
First Name:
Middle Name:
Street Address:
City:
State/Province:
Zip+4/Postal Code:
Phone:
Fax:
Email:

Please answer the following questions, providing detailed examples.
Note: The boxes below are expandable and will accommodate an indefinite amount of text. It is suggested that you type your text elsewhere and copy and paste the information electronically into the boxes.


1. Volunteer Effort Utilized by Teacher
For classes taught during current academic school year.

Did you utilize volunteers in the classroom?
Yes No

If yes, please list below the number of volunteers per class and the number of volunteer hours per class.

Please explain how the volunteer(s) effectively participated in the program.


2. Classroom Activity
How were the AWIM materials obtained?
Did your students provide an AWIM presentation or demonstration of accomplishments?
Yes No

If yes, please explain how, where and to whom.

Was there a process used to evaluate student presentations or demonstrations?
Yes No

If yes, please explain.

Was the AWIM curriculum supplemented with other classroom activities?
Yes No

If yes, please explain.

Was there use of student teams during the implementation of AWIM?
Yes No

If yes, please explain.

Was there team-teaching that students used during the implementation of AWIM?
Yes No

If yes, please explain.

Were parents involved in the implementation of AWIM?
Yes No

If yes, please explain their involvement and commitment.


3. Student Outcomes
Was there any change of attitude observed in the students toward math and science while involved in AWIM?
Yes No

If yes, please explain.
Was there an increase of awareness of the engineering profession as a result of the AWIM program?
Yes No

If yes, please explain.

Do you think an interest in an engineering career was demonstrated by students as a result of the AWIM program?
Yes No

If yes, please give examples.


4. Supporting Material
Were there any awards or recognition received for the AWIM activities?
Yes No

If yes, please explain.


Provide a statement as to why you feel this teacher deserves this award.


Provide a statement below from one volunteer regarding the AWIM partnership experience.


Provide statements below from several students regarding their participation in the AWIM program.

The submission of supporting material is encouraged. These may include news articles, local/regional publicity, videos, and/or classroom photos. All supporting documents must be in an electronic format.
Please mail information to:

SAE Awards & Scholarships Programs Office
400 Commonwealth Drive
Warrendale, PA 15096-0001

I hereby acknowledge that the information submitted herewith is true and correct.

Questions? Email awards@sae.org




Submit
Nomination Deadline: March 1

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