ACRES American Council on Rural Special Education

ACRES Forms Online

ACRES Exemplary Program Award Nomination

Due: February 15th

The American Council on Rural Special Education (ACRES) invites nominations (including self-nominations) for the ACRES Exemplary Program Award.

PART I PROGRAM NOMINATOR

First Name:
Last Name:
Position:
Institution/Agency:
E-mail:
Address:
City:
State:
ZIP:
Bus. Phone:
Home Phone:
Please describe how the nominator is associated/familiar with the nominated program. (please limit to 25 words).
I certify that the information contained in this nomination form is accurate to the best of my knowledge, and that the program contact person has reviewed and verified all information contained herein.

PART II EXEMPLARY PROGRAM NOMINEE

Title of Nominated Program:
Program Contact:
Position:
Institution/Agency:
E-mail:
Address:
City:
State:
ZIP:
Bus. Phone:
Home Phone:
Listed below are the eight (8) categories for the ACRES Exemplary Program Awards. Please check the most appropriate category for the nominated program under consideration. (If you are unsure about which category your program fits, see our website, www.acres-sped.org, for more information.)
CATEGORY 1: Preservice/Inservice Training
CATEGORY 2: Infant and Early Childhood Intervention
CATEGORY 3: Vocational Training and Transition
CATEGORY 4: Interagency Collaboration
CATEGORY 5: Services to Persons with Disabilities in the Least Restrictive Environment
CATEGORY 6: Cross-Cultural Services
CATEGORY 7: Educational Technology
CATEGORY 8: Research and Evaluation

PART III

Please answer the following questions concerning the nominated program.

1. Number of students served by the program:
Explain:

Average daily attendance in the program:

2. The population density per square mile of the district/county in which the program is based:

3. Please check one or more of the following categories that are applicable in the nominated program. rural/small public school
university training program
business/school partnership
local education agency
school board
state education agency
adult education
intermediate education agency
other, please specify:


4. Please check one or more of the following educational levels that are applicable to the nominated program. infant/preschool
undergraduate
elementary school
graduate (although on-the-job trainees directly serve IWENS preschool through high school ages)
middle school
junior high
high school
adult training


5. Describe the goals, objectives and specific activities of this program. (please limit to 500 words)

6. What rural school special education issues does this program address (e.g. low incidence handicaps, limited fiscal resources, small staff, etc)? (please limit to 50 words)

7. Describe the components of this program that are distinctly rural focused. What is different about this approach/program than that used in a suburban or urban location? (please limit to 300 words)

8. Describe the ways that this school program involves the community (e.g. agencies, parents, business, volunteers, corporations, etc.). (please limit to 100 words)

9. What specific evaluative/research data are available that corroborate the high quality of this program; i.e., documented data, statistics measurable outcomes, etc. (please limit to 100 words)

10. Describe the specific sources of funding for this program, including cost effective measures the program has employed. (please limit to 100 words)
ADDITIONAL SUPPORTIVE DOCUMENTATION
11. Please describe any additional information/documentation that enhances the overall quality of this program. (Publications, awards and honors, unique characteristics, innovative strategies, etc.). (please limit to 250 words)

12. Please mail-in or scan and upload two (2) letters of recommendation from individuals in the community who are knowledgeable about the nominated program. (Note: These should be in positions that allow them to objectively assess the effectiveness of the program.) Please include their names, addresses, and phone numbers.

Option 1: Mail-In Letters
Mail letters to:
Lori Garnes
Minot State University
500 University Avenue West
Minot, ND 58707

Option 2: Upload Letters
Letter 1:
Letter 2:

Nominations and materials must be received by February 15

Questions? Contact Lori Garnes at (701) 858-3139 or e-mail garnesl@minotstateu.edu.

Because letter files must upload, submission may seem slow

NOTE: If you do not receive a success message, or to report other problems, e-mail webmaster@acres-sped.org.