AEA 267 ABC Award
(Above and Beyond the Call of the Paraeducator Profession)
2014-2015 Official Nomination Form (page 1 of 4)
Directions and Considerations:
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This form is the only form of nomination that will be considered
All sections of this form must be completed by providing specific examples of each of the competencies and accomplishments
Two separate nomination forms per candidate – no more, no less.
Attachments will not be considered
! Deadline for submission is: February 20, 2015
! Submit the completed form to:
Linda Vann, AEA 267 Paraeducator Program Coordinator
AEA 267 Cedar Falls Office
3712 Cedar Heights Drive
Cedar Falls, IA 50613
Via email to: [email protected]
Or fax to: (319) 273-8219
Paraeducator Name:
School District and Building: ___________________________________________________
Work Address: ______________________________________________________________
Work Phone:
___________ Position: _________________________________________
Home Address: _____________________________________________________________
Home Phone: ____________ Email Address: ______________________________________
Submitted by:
Name: ____________________________________________________________________
School District and Building: ___________________________________________________
Work Address: ______________________________________________________________
Work Phone: ____________ Position: _________________________________________
Email Address: _____________________________________________________________
AEA 267 ABC Award, Official Nomination Form, page 2
Standards/Competencies
In the spaces below, provide specific examples of how the paraeducator meets the required paraeducator standards and competencies.
1.
Standard/Competencies
Give examples of how this person meets the Foundations standard and competencies (recognizes the developmental stages of students; believes
every student can learn; recognizes that learners have unique needs; demonstrates knowledge of Iowa Core; respects the roles of paraeducators & teachers)
Foundations
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3.
Learning Environment
Give examples of how this person meets the Learning Environment standard and competencies (follows prescribed health, safety & emergency
classroom & school procedures; organizes materials to support teaching & learning; facilitates integration of students with diverse needs in various settings; promotes a
safe, positive learning environment; functions in small groups, large groups, & tutoring settings)
1.
2.
3.
Content & Instruction
Give examples of how this person meets the Content and Instruction standard and competencies (assists with learning activities &opportunities to
accomplish instructional objectives; supports high expectations that are shared, clearly defined & appropriate; monitors student progress & reports objective
observations; effectively uses verbal & nonverbal forms of communication with students; assists with the implementation & use of instructional & assistive technology)
1.
2.
3.
AEA 267 ABC Award, Official Nomination Form, page 3
Ethical & Professional Practice
Professional Relationships
Emotional & Behavioral
Give examples of how this person meets the Emotional & Behavioral standard and competencies (models & teaches appropriate behaviors, & social
skills; assists in modifying the learning environment to manage behavior & social skills; recognizes there is a cause or reason for misbehavior & assists in determining
the cause or reason; recognizes, addresses, & reports bullying behavior; recognizes & reports atypical emotional behavior)
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3.
Give examples of how this person meets the Professional Relationships standard and competencies (demonstrates a commitment to work as an
effective team member; fosters a professional & caring relationship with students’ families; develops & maintains positive & professional relationships with students)
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Give examples of how this person meet the Ethical & Professional Practice standard and competencies (follows ethical practices for confidentiality
& abides by the Iowa Code of Ethics; participates in ongoing professional development; demonstrates the ability to separate personal issues from one’s responsibilities
in the workplace; demonstrates awareness of personal biases and refrains from discriminatory practices with teachers & students; abides by the laws of restraint and
seclusion; recognizes & follows decisions made by Individualized Education Program (IEP) Teams
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AEA 267 ABC Award, Official Nomination Form, page 4
Professional Accomplishments and Community Involvement
In the space provided, BRIEFLY describe how this paraeducator goes Above and Beyond the Call of the Paraeducator Profession
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Certification(s) Earned
(e.g., Generalist Paraeducator Certification, Early Childhood Area of Concentration, etc.)
Professional Development Participation
(e.g., participates in school district professional development opportunities, participates in continuing education opportunities or classes, etc.)
School and Community Involvement
(e.g., serves on school committees such as Professional Learning Communities, Building or Grade Level Leadership Teams, Parent Teacher
Organization, local community organizations, etc.) Note: Be sure to spell out any acronyms.