PSTA Nomination form 2005

Primary Science Teaching Awards 2007 AstraZeneca Science Teaching Trust/Times Educational Supplement in conjunction with ASE

Raising the profile of primary science
Recognising talented teachers
Engaging children in exciting science

Open to all Primary Teachers who:

.. are innovative and creative in teaching science
contribute to developing science in their school
.. engage pupils in the excitement and facination of science

Awards will be presented during the ASE Annual Meeting, 53rd-5th Jan 2008

5 Awards: Each of £750 for the school & £750 for the teacher - plus a certificate & ASE Membership for 1 year.

AstraZeneca Teaching Trust Trustee Award - a special award recognising achievements of a teacher working in challenging circumstances. £750 for the school, £750 for the teacher plus a certificate & ASE Membership for 1 year.

MAKE YOUR NOMINATION NOW-using the online form below .................Further details Email: pamjenkins@ase.org.uk

Section 1 - Personal Details of Candidate

Name

Address:

Post Code:

Home Tel No.

Date of Birth

Age:

Email:

Current position held (nominations for full time teachers only please)

Title:

Date of Appointment:

Name of School

Address:

Tel No

Email

Type of School

No. on roll

Single Sex or Co-educational

Age Range of Pupils

Section 2 - Previous Employment

Date		School/Employer	Post Held
From	To

Section 3 - Referees

Please give the name, address and Telephone number of someone, other than the proposer, who is
knowledgeable of the work of the candidate and to whome reference may be made. Please give home
address if possible, as we may need to contact the referee.

Referee Email

Section 3 - Statement by proposer in the space below, please indicate your reasons for considering the candidate to be worthy of the award. Please include your full contact details and your position held.