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Candidate's Record Form
Outstanding biological/life science teaching is essential
to modern society and to human survival in the future. Such teaching exists,
and the NABT Outstanding Biology Teacher Award program represents a specific
way to recognize such excellence.
NABT invites you to participate in its OBTA program. If
you wish to be considered for this year's award, please complete this form.
To be eligible, you must be presently teaching biology/life science (public,
private or parochial school) and must have devoted a significant portion
of your career to the teaching of biology/life science. A minimum of three
years of teaching experience is mandatory. Recommendations from four individuals
who know of your teaching competence must also be obtained. Please ask
four such individuals to write strong letters of support.
In addition, your Selection Committee may require either
a site visit or videotape of your classroom teaching. Please check below
to see if this is a requirement in your jurisdiction.
( ) A site visit will be scheduled.
(x) A videotape is required of finalists. Do not submit
at this time. Videotape and/or site visit will be required of finalists
only. Finalists will be notified.
Name:
School Name:
School Address:
School Phone:
Home Address:
Home Phone:
School Principal:
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E-mail:
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Local Newspaper:
Address:
Please categorize your school:
Nature: _____Private _____Public
Location: _____Rural _____Suburban _____Urban
Grades: _____7-8 _____9-12
Size: _____0-500 _____500-1000 _____1000+
Average Class Size: _____0-20 _____20-30 _____30+
Please check those courses you took in college/university:
Biological Sciences:
_____ Botany _____ Parasitology
_____ Zoology _____ Cytology
_____ Genetics _____ Endocrinology
_____ Comparative Anatomy _____ Field Biology
_____ Mammalian Anatomy _____ Protozoology
_____ Ecology _____ Marine Biology
_____ Physiology _____ A.P. Biology Workshop
_____ Microbiology/Bacteriology _____ Medical Virology
_____ Histology & Histological Techniques _____ Immunology
_____ Evolutionary Biology _____ Invertebrate Zoology
_____ Other
Other Sciences: Math:
_____ Inorganic Chemistry _____ Algebra
_____ Organic Chemistry _____ Trigonometry
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_____ Biochemistry _____ Analytical Geometry
_____ Physics _____ Calculus
_____ Earth Science _____ Topology
_____ Intermediate Quantitative Analysis _____ Other:
____________________
_____ Chemistry - Independent Study
_____ Other: _______________________
Positions Held (professional, teaching, administrative
in chronological order, beginning with the most recent.)
Business/School Position Year(s)
Current Teaching Schedule: Please attach a copy of your
current class schedule.
Education Record: Include Institute(s), special program(s),
scholarships, etc.
College/University Degree Earned Date Major Minor
(continued)
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List Courses taken in the last 3-5 years beyond your last
degree:
Institution Course Semester/Quarter Hours
Please provide any additional information concerning your
professional involvement, such as:
1. Attendance at national conventions or state/regional/province
science meetings of at least one day's duration within the past five years.
Include information on presentations you have made, participation on committees,
and/or awards/special recognition achieved.
2. Memberships in scientific and/or educational organizations
(local, state, provincial, national). Please list the titles of professional
journals that you read regularly.
3. Other school or community activities related to your
profession in which you have been involved.
4. Articles published and/or any additional information
you feel is important to your teaching effectiveness (e.g., curriculum
development and other contributions you have made on the local, state,
provincial, or national levels). (Use additional sheets of paper, if necessary.)
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Write a brief informative essay about your role as a biology/life
science teacher. Include your philosophy of biological science education
for high school/middle school students, relating this to your community
and the nation. Please also comment on your teaching techniques and strategies.
(Maximum three (3) pages, double-spaced.) Send your essay, along with this
application package, to your OBTA Director.
I have asked the following persons to submit recommendations
on my behalf.
Name Title/Position Address
1.
2.
3.
4.
I affirm that I have completed this application form and
that all information on this form is true and verifiable.
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(signature)
Please also furnish the name and address of your science
supervisor/coordinator: ______________________
REMINDER
Be sure to send the original and four (4) copies of this
form and all additional attached pages to your OBTA Director! Also send
one (1) copy of the videotape of your teaching.
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Note: OBTA recipients are chosen by an independent
Selection Committee composed of biology teachers, science supervisors,
school administrators, and representatives from industry in each jurisdiction
where the award is presented. Only one recipient may be selected each year
per jurisdiction. The decision of the selection panel is final, and it
is the policy of the NABT National Office and its staff, officers, and
Board of Directors not to interfere in the evaluation process. All application
materials and evaluation instruments as well as names and addresses of
nominees and Selection Committee members are completely confidential and
may not be released to the public. All general questions about the program
or the evaluation process should be directed to the NABT National Office,
12030 Sunrise Valley Dr., #110, Reston, VA 20191-3409; (800) 406-0775.