Chamber of Commerce/South Lane School District

Chamber of Commerce/South Lane School District

Employee of the Year Recommendation Form

South Lane School District and the Cottage Grove Area Chamber of Commerce want to recognize teachers and classified employees for their outstanding work that benefits our students. A teacher and classified employee of the year will be chosen in December, and will be recognized at the annual Chamber of Commerce Dinner on January 21st 2017. Please complete this form for a teacher or classified employee, and send it to Brian McCaslineby December 8th, 2016(see bottom of form for contact information). The form can be filled on computer and sent via email, or it can be filled out by hand and mailed. Attach additional pages if necessary. If you have any questions about the recommendation process, please contact Brian McCasline at 541-942-3381 ext. 133. All nominees will be notified of their nomination, and will be given pages 2-3 of their nomination form.

Your Information

Name:
Job Title:
Relationship to Nominee:
Email Address:

Nominee information

Name:
Position:
School/Work Site:
Total Years in Education (if known):

References

Please include the names and contact information of 3 others who would be good references for the nominee. These could be colleagues, community members, supervisors, etc. who would be knowledgeable about his/her work.

Name:
Relationship to Nominee:
Email:
Name:
Relationship to Nominee:
Email:
Name:
Relationship to Nominee:
Email:

Information about the Nominee

Please provide the following information about your nominee. Please include examples, or stories that will help us know why he or she was nominated for this recognition.

How long has this employee been serving students and our schools (if known)?

Tell us a story that captures the employee’s character and working/teaching style.

What sets this employee apart? What does he/she do that is innovative, creative, inspiring, or especially effective?

Describe the employee’s involvement in school activities, or other activities outside the school setting that show his or her willingness to go above and beyond to support our students and schools.

Is there anything else you want to share about your nominee?

Please return the nomination form to Brian McCasline by December 8th, 2016.

PO Box 218

Cottage Grove, OR 97424