SELECTION OF MILKEN EDUCATORS

Talent Pool Recommendation Form
Cite evidence of student achievement gains as a result of th
Cite awards the educator has received:
Education

Talent Pool Recommendation Form

We invite you to recommend distinguished classroom teachers and/or principals who have demonstrated all of

the following:

•

Exceptional educational talent as evidenced by effective instructional practices and student learning

results in the classroom and school;

•

Exemplary educational accomplishments beyond the classroom that provide models of excellence for the

profession;

•

Strong long-range potential for professional and policy leadership; and

•

Engaging and inspiring presence that motivates and impacts students, colleagues and the community

Please complete a separate form for each individual including a one-page letter explaining how this person meets

the criteria outlined in this letter. Please include a resume for each recommendation.

Incomplete forms will be eliminated from this process.

THIS IS A CONFIDENTIAL PROCESS.

INDIVIDUALS SHOULD NOT BE AWARE OF THIS RECOMMENDATION.

Recommended Educator:________________________________________________________________

Name

Classroom Teacher ___________ Principal ______________ Other (specify) : _______________

For teachers, grade(s)

currently

teaching: ________ For principals, grade levels in building: _________

____ Reading/English/Language Arts ____ Science ____ Mathematics

____ Social Studies ____ Fine Arts ___ Other (please specify): _________

Total Years in Education: _______ If a principal, number of years as an administrator: _____________

Will this person be at the same school site next year?

__________________________________________

School District :_______________________________________________________________________

School Name:_________________________________________________________________________

School Address:_______________________________________________________________________

Street City State Zip

School Phone: (____)_______________Ext:______School Fax: ( __ )___________________________

Educator's Supervisor: __________________________________________________________________

Name Title

Supervisor's Phone: (____)_____________Ext:______ Supervisor’s Fax: (_____)_________________

Supervisor’s Email: ____________________________________________________________________

RATE

educator from 1-10 (10 being highest) on the following four criteria and provide a paragraph to explain

your rating. Be detailed and thorough, with examples whenever possible.

_______

Exceptional educational talent as evidenced by effective instructional practices and student

learning results in the classroom and school.

_____________________________________________________________________________________

_______

Exemplary educational accomplishments beyond the classroom that provide models of

excellence for the profession. Include committees, mentoring, awards, publications, presentations.

_____________________________________________________________________________________

_______ Strong long-range potential for professional and policy leadership, i.e., predict the educator’s

potential to remain in education for at least 15 more years and demonstrate leadership in the profession.

_____________________________________________________________________________________

_______

Engaging and inspiring presence that motivates and impacts students, colleagues and the

community

Do students perform at higher levels due to the educator, pursue certain careers, credit their

success to the educator, etc.?

_____________________________________________________________________________________

Cite evidence of student achievement gains as a result of the educator’s practices:

_____________________________________________________________________________________

Cite awards the educator has received:

____________________________________________________________________________________

Other comments:

____________________________________________________________________________________

Education

Schools Attended Degrees Graduation Years

____________________________________________________________________________________

Indicate ethnicity of educator being recommended:

____ White ____ Black or African American

____ Asian ____ Native American Indian or Alaska Native

____ Hispanic or Latino ____ Native Hawaiian or Other Pacific Islander

Please list the names and phone numbers of three references other than you for the educator. We will call and

interview them. They should know the educator currently and very well.

_________________________________________________(____)____________(_____)_______________

Name Title Phone (W) Phone (H) Email

_________________________________________________(____)____________(_____)_______________

Name Title Phone (W) Phone (H) Email

_________________________________________________(____)____________(_____)_______________

Name Title Phone (W) Phone (H) Email

_________________________________________________(____)____________ (_____)_______________

YOUR Name Title Phone (W)

Phone (H) Email

Return completed letter(s) and form(s) to: