Massachusetts Distinguished Educators

Distinguished Educator Recommendation Form

We invite you to provide information regarding a distinguished elementary and/or secondary classroom teacher, specialist, and/or principal who demonstrates of the following:

The ability to reflect on their work and use anti-racist and culturally and linguistically sustaining practices;
Exceptional educational talent as evidenced by effective, innovative, and culturally responsive instructional practices that promote deeper learning;
Exemplary educational accomplishments and leadership beyond the classroom that provide models of excellence for the profession;
Contributions to education that are largely unheralded yet worthy of the spotlight;
Strong long-range potential for professional and policy leadership; and
An engaging and inspiring presence that motivates and impacts students, colleagues, and the community.

Please complete a separate form for each recommendation.

Please include a resume for each recommendation.

Alternatively, you may submit a one-page letter explaining how this individual meets the criteria outlined in this form. If you choose to submit a letter as an alternative to completing this form, please email Grace.Kingsbery@mass.gov directly with your submission and any questions.

THIS IS A CONFIDENTIAL PROCESS.
INDIVIDUALS SHOULD NOT BE AWARE OF THIS RECOMMENDATION.

1. Name of recommended educator *This question is required.

2. Please upload the educator's resume, and ensure that it includes information regarding the educator's education. (This does not need to be the most up-to-date version. Simply share the most recent version which you have access to.)

File: {{filename}} delete

3. Type of educator *This question is required.

Please enter an 'other' value for this selection.

For teachers, grade(s) currently teaching: *This question is required.

For principals/assistant principals, grade levels in building: *This question is required.

Subject(s) (Multiple may be selected.) *This question is required.

Reading/English/Language Arts
Social Studies
World Languages
Science
Fine Arts
Mathematics
Other - Write In Please enter an 'other' value for this selection.

4. Total years in education *This question is required.

If a principal/assistant principal, number of years as an administrator: *This question is required.

6. School district *This question is required.

7. School name *This question is required.

8. School address and phone number

9. Educator's supervisor (name and title) *This question is required.

10. Supervisor's phone number *This question is required.

11. Supervisor's email *This question is required. This question requires a valid email address.

Please rate the educator on a scale of 1-10 for the following questions:

12. Exceptional educational talent as evidenced by effective instructional and innovative practices and student learning results in the classroom and school. *This question is required.

	1	2	3	4	5	6	7	8	9	10
Least	1	2	3	4	5	6	7	8	9	10	Most

13. Please explain your rating. (100 words suggested)

14. Exemplary educational accomplishments and leadership beyond the classroom that provide models of excellence for the profession. Include committees, mentoring, news items, publications, presentations. *This question is required.

	1	2	3	4	5	6	7	8	9	10
Least	1	2	3	4	5	6	7	8	9	10	Most

15. Please explain your rating. (100 words suggested) *This question is required.

16. Strong long-range potential for professional and policy leadership including teacher leadership and mentoring. Predict the educator’s potential to remain in education for at least 25 more years and demonstrate and increase leadership impact in the profession. *This question is required.

	1	2	3	4	5	6	7	8	9	10
Least	1	2	3	4	5	6	7	8	9	10	Most

17. Please explain your rating. *This question is required.

18. Engaging and inspiring presence that motivates and impacts students, colleagues and the community. Do students perform at higher levels due to the educator, pursue certain careers, credit their success to the educator, etc.? *This question is required.

	1	2	3	4	5	6	7	8	9	10
Least	1	2	3	4	5	6	7	8	9	10	Most

19. Please explain your rating. (100 words suggested) *This question is required.

20. Cite evidence of student achievement gains as a result of the educator's practices, even if from a previous year. (100 words suggested) *This question is required.

21. Cite awards the educator has received.

22. Other comments, including leadership or instructional practices.

23. Indicate race and/or ethnicity of educator being recommended. (Multiple may be selected.) *This question is required.

Asian
Black or African American
Hispanic/Latino
Native American/Alaska Native
Native Hawaiian or Other Pacific Islander
White
Other - Write In Please enter an 'other' value for this selection.
Unknown
Choosing not to respond

24. Please list the names, phone numbers, and emails of three professional references other than you for the educator. We may call and talk to them. They should know the educator currently and very well. (They should either be a current colleague, or have worked with the educator as recently as one year ago.)
*This question is required.

Space Cell	Name	Title	Phone (Work or Home)	Email
Professional Reference 1	Professional Reference 1: Name	Professional Reference 1: Title	Professional Reference 1: Phone (Work or Home)	Professional Reference 1: Email
Professional Reference 2	Professional Reference 2: Name	Professional Reference 2: Title	Professional Reference 2: Phone (Work or Home)	Professional Reference 2: Email
Professional Reference 3	Professional Reference 3: Name	Professional Reference 3: Title	Professional Reference 3: Phone (Work or Home)	Professional Reference 3: Email

25. Your Name *This question is required.

26. Your Title *This question is required.

27. Your Phone Number *This question is required.

28. Your email address *This question is required. This question requires a valid email address.