CETPA Award Application Form

Nominee Information

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First Name *	Last Name *
Title *
Organization *
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Nomination I Am Nominating Myself

Your Contact Information

(Fill out if not nominating yourself)

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CoSN Membership: I am a COSN Member
CETPA Membership I am a CETPA Member I am Nominating a CETPA Member

Background Information

Effective Leadership * How did this nominee demonstrate effective leadership in using information technologies to increase opportunities and accessibility for student learning and staff effectiveness?
Community Building * How did this nominee build community, with parents, teachers and educational leaders to effect the desired changes?
Innovative use of Technology * How did this nominee demonstrate effective leadership in using information technologies to increase opportunities and accessibility for student learning and staff effectiveness?
Impact * What is the major impact of this nominee's achievement?
Private/Public Sector Partnerships * How did this nominee develop public and/or private partnerships and policies that provide connectivity to learners in schools?

Last Steps

I have:

Verified that the information about the award nominee that I am submitting is correct to the best of my ability. *
Contacted the nominee for permission to submit his/her name for this award. *

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Upcoming Events

2013 CETPA Clinic
05/17/2013 - 05/17/2013
Santa Clara County Office of Education

Annual Conference 2013
11/19/2013 - 11/22/2013
Pasadena, California

Annual Conference 2014
11/18/2014 - 11/21/2014
Sacramento, California