Test Form Page I would like to nominate a teacher deserving of the Monsignor Gerald Lawrence Lewis Award for Excellence in Teaching. Teacher's Full Name: Teacher email: School: School Parish: Principal: Principal email: School Address: City: State: NCALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip: My Name: Address: City: State: NCALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip: Phone (day): Phone (evenings): My email: Please leave this field empty. NOMINEE FORM Nominee Information & Questionnaire ACCEPTING THE NOMINATION Please enter your full name and indicate if you accept or decline the nomination: AcceptDecline If you decline the nomination, please scroll to the bottom and click the "Submit" button. If you accept, please proceed with the rest of the form. All fields are required. Thank you! I. GENERAL INFORMATION Deanery: Name: Name of School: School Parish: Name of Principal: Principal Email: School Address: School Telephone: Teaching Assignment: Total Years Teaching in Raleigh Diocesan Schools: Years in Present Position: Total Years Experience: Colleges and Universities Attended and Degrees Earned: Home Address: Home Telephone: Email: Name of Pastor: Pastor Telephone: II. Describe in 75 words or less each of the following: Describe your personal feelings and beliefs about teaching, including your own ideas of what makes you an outstanding teacher. words. Please limit to 75 words or less. Describe the rewards you find in teaching at a Catholic School. words. Please limit to 75 words or less. What do you hope your students remember most about you as a teacher? words. Please limit to 75 words or less. Reflecting on the past three to five years: describe a time/event that made you feel joyful and/or inspired about the work you do. words. Please limit to 75 words or less. What was the most valuable thing you learned over the past three to five years that impacted your students or your instructional style/methods? words. Please limit to 75 words or less. If selected as the Recipient of the Msg. Lewis Award, what would be your message to the teachers in our Catholic schools who are striving for excellence? words. Please limit to 75 words or less. III. Professional Association Memberships Awards and Recognitions Interests and Community Involvement Extracurricular Involvement IV. Letters of Support Please attach one (1) file containing all three (3) and the statement of the pastor’s endorsement and his signature (if he was not one of the people who wrote a letter of support). Acceptable file formats include pdf, doc, and docx. Please leave this field empty. Please verify that you have completed all sections of the form according to the instructions at the top. Once complete, please click "Submit". Thank you and congratulations again on your nomination!