Dr. Carlo Rodriguez Champion of School Choice Award

Online Nomination Form

The deadline for submission of the nominations is Friday, May 30, 2008.

Please complete all questions or requests with evidence submitted where appropriate.  Use the Evidence of Impact Guide to help identify information and evidence needed.   You may complete this form online or print it out and submit information by email file attachment. Submit email file application to harriska@nova.edu. Also see, Scoring Rubric.

Name:
Title:
Contact Person: (if district)
Address:
Email:
Phone:
Your Name: (person completing nomination)
Relationship to Nominee:
Email:
Phone:
Why should the nominee receive the Champion for School Choice Award?  Give an overview of accomplishments that clearly describes scope and degree of impact. (See Areas of Impact Guide)
Evidence of impact:  (See Areas of Impact Guide)
Name of District or Individual, including job title:
Overview of accomplishments and areas of impact: (Such as: Inter-district or inter-agency collaboration and/or agreements that remove barriers and increases choice, overall impact on school, district and state school choice practices, substantial increase in equitable school options, innovative transportation plans, parent awareness and assistance, marketing strategies that reach targeted population and empowers families, and/or practices that promote equity)
Explain how the nominee has dedicated his, her (individual) or their (district) time, knowledge, expertise or resources to achieve an array of options and equitable practices for offering and/or promoting school choice.  Identify a direct relationship between the nominees’ actions and an increase in the amount and quality of school options, and/or removal of barriers to enrollment resulting in increase access for students.
How has nominee increased the array of options or improved access to existing options?
Provide data, survey results or anecdotal evidence:
Describe what outcomes the nominee has achieved that have directly impacted students and their families by expanding their option for a quality education. Provide evidence of a significant increase in the families opting for school choices, and/or increases in achievement, program retention, and improved family satisfaction ratings.  Demonstrate how influence or actions of the nominee has addressed population that previously had actual or perceived limited school choice.
Numbers of students and families that have been affected by the efforts of the nominee:
Identify specific populations that have benefited from the nominee’s efforts: