Innovative Teachers Leadership Award

ITLA

Note : Please follow the Instructions as specified in the ITLA template guideline.doc file, available in the Teacher’s Competition folder to complete this template

Index

1. Section – A

• Applicant’s profile

2. Section - B

3. Section – C – Letters of Support

a. Professional Reflections

b. Teacher’s PPT

c. Community Work

a. Administrator/ Principal/ Regional Co- ordinator

b. Parent or Community Member

c. Colleague

Section APersonal Profile

Registration Segment (Public / Private School, Government School, Special Category*)

 

Name of the Teacher  

Date of Birth (MM/DD/YY) :

Address for Communication

House No. Street

Town District

State PIN code

Email Id : (live or hotmail )

Personal Contact No.

Landline with STD Code Mobile

Mobile  

School Name and Address  

Languages familiar with  

Teaching Focus e.g. Maths, Science, Social Studies etc.

 

Classes Taught  

I access my PC at: (Home/ School/ i-café/Do not access)

Do you have a Passport? (Yes/No)

If YES, Passport No.

Expiry Date

I would like to receive communication from Microsoft on such events and other activities: (Yes/No)

Section B

a. Professional ReflectionsDouble Click on the Icon below to write about your

professional Reflections.

Professional Reflection

Section-B

Teacher’s PPT. (Best Lesson plan)

Name of the presentation submitted for the contest

Class or age group(ppt. meant for which class or age group)

Objective

After inserting the object (refer guidelines) Resize and place your embedded Ppt. here (you will see the first slide of your lesson plan)

Section-B

List of Teacher’s work (other than the one submitted as ITLA contest entry):

S.No Name of the Lesson Plan Target Class

No. of Students Covered

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

Section-B

Community Work – Screenshot 1 (scanned document)

A brief synopsis of the screen shot ( in 1 or 2 lines):

Section-B

Community Work – Screenshot 2 (scanned document)

A brief synopsis of the screen shot ( in 1 or 2 lines):

Section-B

A brief synopsis of the screen shot ( in 1 or 2 lines):

Section-B

Community Work – Screenshot 3 (scanned document)

List of other work done towards community (Do not repeat the scanned items):

S.No Name of the Community Work

Beneficiaries & remarks

Section-B

Section CLetters of Support

Letter of Support (Scanned copy) Administrator/ Principal/ Regional Co- ordinator

Section-C

Letter of Support (Scanned copy) : Parent or Community Member

Section-C

Letter of Support (Scanned copy) : Colleague

Section-C

Message from the Teacher:

Acknowledgement