Barbara Spreistersbach Application form 

Copy and paste application and unit prompts into Microsoft Word 97 or later, along with the supporting documents, and email as
attachments to elaine_regier@sde.state.ok.us  by June 15

(If necessary, you may save your files as .txt files)

The application for this award shall consist of the following:

1.    The nominating library media specialist's statement of nomination. The text should not
         exceed 500 words.

2.            The teacher's statement concerning the importance of resource-based learning and cooperative
          planning and teaching. The statement should not exceed 250 words.

3.            An instructional unit taught jointly by the library media specialist and the classroom teacher
          and organized according to the attached unit planning outline.

4.      A statement by an administrator in whose school the nominee currently teaches.

Using the unit planning form as outlined below, describe the specific curriculum unit you and the nominee planned and taught together.

I.          SCHOOL LIBRARY MEDIA SPECIALIST SUBMITTING APPLICATION:

            A.        Name:  ________________________________________________________________

            B.         School:  _______________________________________________________________

            C.        School Address:  ________________________________________________________

            D.        Home Phone:  __________________________________________________________

            E.         Email Address:  _________________________________________________________

II.   NOMINEE:

            A.        Name:  __________________________________________________________________

            B.         School:  _________________________________________________________________

            C.        Grade/Subject Area:  ______________________________________________________

            D.        School Address:  __________________________________________________________

            E.         Home Phone:  ____________________________________________________________

            F.         Email Address:  __________________________________________________________

NOTE:  On the following pages of this application, please refrain from using the name of the library media specialist, the name of the teacher nominee,
or the name of the school where the library media specialist and teacher nominee work.

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TITLE:

GRADE LEVEL(S):

CURRICULUM APPLICATIONS:

GOAL(S):

COOPERATIVE PLANNING STEPS (Be specific):

COOPERATIVE TEACHING EFFORTS (Be specific):

                A.            The teacher will-

                B.         The library media specialist will-

PRIORITY ACADEMIC STUDENT SKILLS (PASS)

                A.         Content Areas-

                B.         Information Literacy-

ACTIVITIES

                A.         Beginning-

                B.         Developmental-

                C.         Culminating-

RESOURCES NEEDED FOR UNIT

            Designate all materials/Resources/etc., by Title/Name, etc.

EVALUATION

                A.         Methods Used

                        1.         For evaluating students' comprehension:

                        2.         For evaluating the unit:

                B.         Goals

                        1.         Met

                        2.         Modified

                        3.         Extended

                C.         Changes Needed in Unit:

NOTE: Nomination Must Be Received On Or Before June 15