transparentminipegasus.gif (998 bytes)Connecticut Council Of Language Teacherstransparentminipegasus.gif (998 bytes)

AWARD FOR EXCELLENCE

NOMINATION FORM

Please type or print all information very neatly to avoid spelling mistakes.

Name of Nominating Teacher:____________________________________________________________________
Nominating Teacher's E-Mail Address:_____________________________________________
School Name:__________________________________________________________________________________
School Address:________________________________________________________________________________
Phone Number (School)_____________________ (Home)________________________
Superintendent:________________________________________________________________________________

Address:_________________________________________________________________________________

Principal:_____________________________________________________________________________________

Address:_________________________________________________________________________________

Students Nominated Language and Level Numerical Average
(93% or above)
Evidence of Positive Attitude
       
       
       
       
       

Date of Awards Ceremony:_________________________________

_____CT COLT member (fee paid)

_____Non-CT COLT member, $25.00 one year membership enclosed

_____# students X $3.00

_____Total Enclosed (check payable to CT COLT)

Mail form and check to the address below.
Make checks payable to
CT COLT.
Forms received after May 1, will not be accepted.

Maria DeStefanis
386 Sterling Place
Hamden CT 06514

If there are questions, call Maria DeStefanis
at
(203)
281-0899

Awards