Massachusetts Department of
Elementary and Secondary Education
75 Pleasant Street, Malden, Massachusetts 02148-4906
Telephone: (781) 338-3000
TTY: N.E.T. Relay 1-800-439-2370
2016-2017 Educator Effectiveness Teacher Advisory Cabinet
Instructions for the Candidate: Please provide this form to your current principal or another colleague or district
leader who can speak to your capacity to participate meaningfully in the Teacher Cabinet.
Instructions for the Recommender:
 Please complete this form and write a letter of support (no longer than 1 page).
 Either email or mail the form and letter of support to Ben Peisch by August 1st.
 If emailing, please scan this form and attach it, along with your letter, in an email to Ben Peisch
at benjamin.peisch@doe.mass.edu.
 If mailing, please send this form and your letter of support to:
Massachusetts Department of Elementary and Secondary Education
Attn: Ben Peisch
75 Pleasant Street
Malden, MA 02148
 Please note: All information included in the form and accompanying letter will be confidential.
Recommender’s Information
Name:
Relationship to Teacher:
Email Address:
Role:
District:
Phone Number:
Information about the Nominated Teacher:
Teacher’s Name: _____________________________________________________
Compared to other teachers you have encountered in your professional career, please indicate how you would
rate the applicant in the following areas. If the applicant is not in the top 25%, leave that row blank. If you do
not know enough about a particular area to offer information, select N/A for that row.
Top 2%
Top 5%
Top 10%
Top 25%
N/A
Teaching practice
Leadership in the school/district
Raising student achievement
Collaboration with colleagues
Solutions-driven mindset
Ability to effectively engage with people with
different perspectives
Communication skills
Do you feel confident recommending this educator to be on the Teacher Advisory Cabinet? Yes
Comments (Optional):
No