DAC of the Year Nominations

1

Nominee's First Name Required field

2

Nominee's Last Name Required field

3

In which district does the Nominee work? Required field

4

What is the Nominee's current job title? Required field

5

How many years of experience does the nominee have as an assessment coordinator? Required field

6

Is the Nominee a member of KAAC? Required field

Yes
No
I don't know

7

Please write a brief narrative describing the nominee’s: 1) professional knowledge of assessment in KY; 2) demonstrated leadership in assessment; and 3) evidence of commitment to student learning. Required field

Please gives us your contact information as the nominator of this candidate.

8

Your First Name Required field

9

Your Last Name Required field

10

What is your job title? Required field

11

What is your email address? Required field

12

What is your address? Required field

Please give us the contact information of two (2) additional persons in the School/District who support this nomination.

First additional person in support of this nominee

13

First Name Required field

14

Last Name

15

What is the job title of the additional supporter of this nominee? Required field

16

What is the email address of additional supporter of this nominee? Required field

17

What is the Address of the additional supporter of this nominee. Required field

Second additional person in support of this nominee

18

First Name Required field

19

Last Name

20

What is the job title of the additional supporter of this nominee? Required field

21

What is the email address of additional supporter of this nominee? Required field

22

What is the Address of the additional supporter of this nominee. Required field