WNYT-TV TOP TEACHER NOMINATION FORM

See reverse side for rules or log on to www.wnyt.com

Name of Teacher____________________________________ School ____________________________________________

School Address/Town_________________________________________ School Phone ______________________ County___________________ Position ___________________________ Years in Position __________ Nominated by __________________________Phone #______________ Relationship to Educator_______________________________________

***All submissions are due by November 8, 2013*** Return to WNYT in one of three ways:
ON-LINE: WWW.WNYT.COM FAX: 518-436-8524 Att: TOP TEACHER

MAIL: NEWSCHANNEL 13 TOP TEACHER WNYT-TV, 715 N. Pearl Street, ALBANY, NY 12204
All submissions must be faxed, postmarked or sent on-line by November 8, 2013.

Please use page 2 to tell us about the teacher and why you are nominating him/her for this award. Please include as much information as you can. Explain how this educator has gone above and beyond the call of duty and how he/she positively impacts students and their performance in school and the community. Also, describe extra curricular/volunteer activities that the educator is involved in and any additional information regarding their contributions to the field of education.

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Please attach more pages if needed.

Purpose and Rules for

TOP TEACHER

on WNYT-TV, NewsChannel 13 Purpose:

The purpose of NEWSCHANNEL 13s TOP TEACHER is to reward professionals in the field of
education (grades K-12) in the Capital Region for outstanding achievements in a learning environment. This cooperative effort seeks to show the community that its future is indeed in good hands. It also will reward those educators who are making significant contributions to our communities.

Rules:
1. All nominations must be faxed, postmarked or emailed by November 8, 2013. All nominations
become the property of WNYT. 2. Representatives of WNYT will choose 13 teachers to be honored in a weekly news series. The decisions of these representatives will be final. 3. These educators (grades K-12) will be representative of professionals in the Capital Region who have positively influenced their students. 4. All nominees must be currently employed by a state recognized educational facility located in the Capital Region.

5.

Family members/relatives of employees of WNYT-TV employees or SEFCU eligible.

employees are not