REFERENCE STATEMENT FORM

THE ACS DIVISION OF CHEMICAL EDUCATION
SOUTHEAST REGION AWARD FOR EXCELLENCE
IN HIGH SCHOOL TEACHING

DEADLINE: For Local Section nominations: To Be Determined by the Local Section
DEADLINE: For transmitting nominations to be considered for the regional award: June 1, 2008

Nominations for the Southeast Region Award for Excellence in High School Teaching is a two-step process. First nominations must made to each Local Section. Then the Local Section must transmit those nominations to the SERMACS Awards Committee. This form is one of a set of 3 forms provided by the Executive Committee of the Southeast Regional ACS meeting for transmitting nominations to the SERMACS Awards Committee. These forms may also be used by Local Section Awards Committees to gather data for Local Section High School Teacher Awards. Please notify Greg-Grant@utc.edu if there are problems using the forms.

The deadline for submitting the nomination for the Regional Award is June 1, 2008. The Local Section deadlines are determined by each Local section. However, if these forms are used to gather data for Local Section nominstions, then then the SERMACS HS Committee strongly recommends that this and other forms be sumitted no later than April 1, 2008. The responses submitted by that date will be forwarded the Local Section chair or his/her designate to select the nominee for the regional award.

Any individual, except a member of the awards selection committee or a current student, may nominate or support a nominee during any given award year.

The Regional Award (not the local section award) carries a $1000 honorarium and will be presented during the Southeastern Regional Meeting of the ACS, which will be held on November 12-15, 2008 in Nashville TN.

Supporting documents describing this award:

• Information and Guidelines
• Scoring Rubric

REFERENCE INFORMATION

Name:

City:

State: State Alabama Georgia Florida Kentucky Mississippi North Carolina Puerto Rico South Carolina Tennessee Virginia Zip:

Telephone:

E-mail:

In what capacity are you writing a reference:

- Nominator
- Current principle or supervisor
- Other reference; student, parent of student, colleague, etc.; please describe:

(optional)

Which nominee has asked you to write a reference:

Name:

School:

City:

State: State Alabama Georgia Florida Kentucky Mississippi North Carolina Puerto Rico South Carolina Tennessee Virginia

The reference cannot currently be a student in the nominee's class. Please verify this requirement:

I certify that I am NOT currently a student in the nominee's class.
I AM currently a student in the nominee's class; this response will invalidate the you as a reference.

Submit a narrative statement of no more than 1,000 words. Some of the points to consider:

• The quality of the nominee's teaching. Unusually effective methods of presentation should be emphasized.
• The nominee's ability to challenge and inspire students.
• Extracurricular work in chemistry or a chemical science by the nominee, including science fairs, science clubs, and activities that stimulate the interest of young people in chemistry and related sciences.
• A willingness to keep up-to-date in the field, as evidenced by the pursuit of a higher degree in chemistry or a chemical science, enrollment in refresher courses and summer institutes, regular attendance at scientific meetings, membership in professional organizations, and other means of self-improvement.
• Evidence of leadership and/or active involvement within the profession.

If you wish to prepare this statement in a word processor, please copy and paste the text into the box below: