Golden Apple Award

Golden Apple Award

Teacher’s

Application Form

Nominee Information

Congratulations!

Top of Form

You have been nominated for a Golden Apple Award. Please complete this 5-page form and make five (5) complete copies, then return themto your principal by February19, 2016.

Your Name: Date:

Bottom of Form

Top of Form

Address:

Parish:

School Information

Name and address of the school in which you presently teach:

School or Parish Pastor/Priest/Chaplain who can attest to your practice and knowledge of faith and moral character:

Name of Nominator:

( ) Parent ( ) Teacher( ) Parent and Student

Nominee’s Signature Date

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Nominee Information Form

Professional Experience

Dates

Start with most recent

/

School and Location

/ Courses Taught or Position
Education
Dates
Start with most recent / Institution and location / Degree

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Certification

Teacher Certification – Elementary and Secondary Teachers, please attach copies of your PA Instructional II certificate and any other certificates earned.
Elementary Teachers - Please attach a copy of your Basic Catechetical Certificate (or Advanced Catechetical Certificate if it has been earned).
Secondary School Teachers – Please include below a list of titles of three years of Religionin-services that you have attended (a total of 6).

Dates

Start with most recent / Type /

Areas

Professional Development
(attach copy of PDE Act 48/45 hours)

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Service
To Church, School, and Community

Dates

Start with most recent

/ Description of Service

Essay

As the nominee, please submit this essay in size 14 font with a maximum of 500 words.

Essay Topic:

“Let us thank all those who teach in Catholic Schools. Educating is an act of love: it is like giving life.” Pope Francis March 1, 2014

In your essay:

- Please illustrate how your vocation as a Catholic School teacher, as described by Pope Francis in the above quote, is an act of love and like giving life

-and explain why you have chosen to teach in a Catholic School

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Checklist

Each nominee should be certain to include the following for submission to the principal. The principal will then submit five (5) copies of the packet to Mrs. Livia Riley, Superintendent of Schools.

Use the checklist below to be certain that your packet is complete.

1. A completed application form – (Please make certain you have included all required documents.)
2. Nominator Letter – Please include only one nominating letter. Additional letters will not be reviewed.
3. Pastor/Priest/Chaplain Letter
4. Principal Letter
5. Nominee Essay

Application Form for Teacher– Page 5 of 5