Name of Teacher

NYC Public High School

School Address

School Phone Number (if available)

How long has the nominee been a NYC public high school teacher? (estimate if necessary)

Subjects taught

Your relationship to nominee

Based on your first-hand knowledge, please comment in detail on the candidate's achievements, according to the following criteria.

Student achievement, progress and outcomes

Teaching style and effectiveness

Innovation and creativity in the classroom environment

Extracurricular mathematics or science activities for students

Success in motivating students with diverse or special backgrounds

Use of technology (where appropriate)

Leadership role in promoting mathematics and science inside and outside the school

Leadership role to encourage students to pursue careers in science and mathematics, including teaching

Your name, email, phone and mailing address so that we can confirm our receipt of your nomination and contact you if we need further information.

Name

Email

Phone

Mailing Address