Teaching Excellence Nomination Form by PK3ing4u

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									                                          University of Houston
                                Office of Academic Program Management

                        Teaching Excellence Nomination Form
                                   Categories 1 -8
Nominee Information
Name:
Department:

Address (campus address preferred):

Phone:
E-mail:
Eligible for (check all that apply):
               Category 1: Teaching Excellence
               Category 2: Provost Core
               Category 3: Innovation in Instructional Technology
               Category 4: Instructor/Clinical
               Category 5: Graduate Teaching Assistant
         ____ Category 6: Community Engagement
         ____ Category 7: Career Award
         ____ Category 8: Distinguished Leadership in Teaching Excellence

Nominator Information
Name:
Dept/Campus Address:
Phone:
E-mail:
Nominee Signature
I consent to the distribution of my nomination portfolio to the members of the Teaching Excellence
Committee.
________________________________                      _____________
Nominee Signature                                              Date

Nominations will be submitted electronically as a .pdf file.
This form should be a cover page to required Teaching Excellence nomination materials.
Please create a single .pdf document containing items 1-8 as outlined in the award announcement and below.
Save and copy the single .pdf document (named with the last name of the nominee) and send via email to Dr.
Heidi Kennedy, hkennedy@uh.edu.

Please present materials as a single .pdf document in the following order:
____ 1. Nomination form (this form)
____ 2. Nomination letter (one page)
____ 3. Statement of teaching philosophy, one page self-reflective statement of your beliefs and goals
concerning teaching and learning and should discuss specifics of how you put your beliefs into practice to
achieve your goals.
____ 4. Curriculum vitae
____ 5. For Category 3 nominees only: statement of innovative teaching using instructional technology.
____ 6. For Category 4 nominees only: department letter outlining nature of candidate’s position and role.
____ 7. For Category 8 nominees only: department letter outlining evidence in support of the candidate’s
nomination as posted under the Category 8 description of evidence of merit for nomination.
____ 8. Spring semester teaching schedule (tentative or anticipated schedule is permitted)

____ Nomination Deadline: 5:00 p.m. Friday, November 4, 2011

								
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