Application for

OASLMS POLLY CLARKE AWARD

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)

Name of Nominee _________________________________________________________________

Position Title _______________________________________________________________________

Home Address ________________________________________ Home Phone _________________

School ___________________________________________________________________________

School Address ______________________________________ School Phone _________________

Email Address ___________________________________________________________________

Nominated By ______________________________________________________________________

Position ____________________________________________________________________________

Grade Level (s) served by your Library Media Center ______________________________________

Number of Students Served by your Library Media Center ___________________________________

Education Background: Give degrees, years obtained, colleges and/or universities ________________

How long in the library media field? _____________________________________________________

Prior Experience:

Year(s)	School	Position

Memberships in Professional Organizations: (Give offices held and years.)

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Professional involvement: (Priority is given to those activities which promote librarianship-committees, presentations, publications.)

Attachments:

1. Mission statement: Write one paragraph which states your goal for the library media program

in your school.

2. Personal statement of accomplishments in the library media field: Should not exceed 250
words and should address processes, procedures, and practices you have incorporated to
make the library media center (and its program) an integrated part of the total school program.

3. Letters of recommendation: No more than two letters from teachers and/or library
supervisors and/or administrators. Letters of recommendation should reflect how the school
program and teaching have been enhanced by the work of the library media specialist.

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

UNIT PLANNING

TITLE:

GRADE LEVEL(S):

CURRICULUM APPLICATION(S):

GOAL(S):

COOPERATIVE PLANNING STEPS (Be Specific):

COOPERATIVE TEACHING EFFORTS (Be Specific):

A. The teacher(s) will-

B. The library media specialist will-

PRIORTTY 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: