SUPERINTENDENT’S AWARD

OF EXCELLENCE 2016

APPLICANT’S NAME

SCHOOL/ORGANIZATION

Please check one (1) box only:

ACADEMICS ARTS MUSIC

JOURNALISM ATHLETICS INNOVATION

LEADERSHIP RESEARCH BEST PRACTICE

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CUSTOMER SERVICE SPECIAL PROGRAMS/PROJECTS

SHORT DESCRIPTION OF ACCOMPLISHMENT:

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TheSuperintendent’s
Award of Excellence POSITION/DESIGNATION E-MAIL/ MOBILE NO.

is presented to an individual or
organization which exhibited ADDRESS
exceptional
RECOMMENDING PERSON/ORGANIZATION
performance/achievement in
Academics, Arts, Music,
Journalism, Athletics, NAME
Innovation, Leadership,
Research, Customer Service and
POSITION/DESIGNATION E-MAIL/ MOBILE NO.
Special Programs/ Projects,
which has significantly
contributed in bringing about
positive changes in the lives of APPLICANT’S SIGNATURE
the members of the community.

APPLICATION FORM
A. Please list down the activities you have participated/undergone and the achievement/awards/recognition
earned/received to show WHY you QUALIFY to benefiting the award.

ACTIVITY/S ACHIEVEMENTS/AWARDS Award-Giving YEAR

(Supply Month and Date)
RECOGNITION Body
2012 2013 2014 2015

B. What are your future plans towards pursuing/sustaining/taking your accomplishment to the next level?

C. What can you recommend/suggest to assist/help individuals/organizations achieved the fullest potentials?

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Please attach the following: APPLICANT’S PERSONAL INFORMATION
1. Proof of Receipt of the
Award/Recognition (e.g. original 1 x 1 ID
and duly-authenticated photocopy Age: Sex: Picture
of certificates, citations, plaques,
medal, etc.); Highest Educational Attainment:
2. Photocopy/documentation (still or School Course Month/Year
motion pictures, narrative, report, Graduated
etc.) of the Work that Earned the
Recognition/Award (e.g. editorial-
journalism, research paper, singing
performance, etc.); and
3. Letter of Indorsement (from
District Supervisor/reputable
individual/organization).

Noted: ____________________________
School Head/Supervisor

APPLICATION FORM