ACSA Region XV
Every Student Succeeding
Recognition Program
2015 - 2016
Nominations Due Friday October 2, 2015
Award Ceremony & reception
Thursday, November 12, 2015
9:30 a.m. – 11:30 a.m.
Light Refreshments Served
Pasadena American Legion
131 N. Marengo Ave. Pasadena, CA
ACSA believes every student deserves equal opportunities to succeed. On every school day throughout California,
dedicated educators and courageous students overcome tremendous obstacles to reach their goals of academic excellence.
Their success is our success; their powerful stories are our inspiration.
ACSA’s Every Student Succeeding (ESS) program honors students who exceed our expectations and the educators who
support them along the way. We are proud to highlight these young men and women who have overcome great obstacles
to succeed. They face life’s challenges head on. Their stories are remarkable and their futures are bright.
Purpose. The purpose of this award is to honor students at all grade levels who have succeeded, against all odds, beyond
expectations or simply won the hearts of the administrators and other educators who helped them achieve their goals. One
student from each region will be honored.
Eligibility. The success of these students should be tied to the work of ACSA administrators and requires background
information about how an ACSA member has contributed to the student’s success. We know that other educators will also
have made significant contributions to their support, including board members, teachers, guardians, community members,
etc.
Nominees should be students who have
Nominees should also be active in:
Nominees can come from programs
made a special effort to succeed and
such as:
have overcome obstacles such as:
 After-school programs
 Returning to school
 Adult Education
 Community service
 Leaving a gang
 Alternative Education
 Student conflict resolution
 Improving their attendance
 At-risk
 Cross-age tutoring
 Changing their attitude
 Bilingual
 Peer mediation
 Overcoming physical and mental
 Continuation School
 Peer tutoring
barriers
Nomination Process. Region VX nominations must be sent directly to Rebecca Summers (rsummers@glendora.k12.ca.us) by no
later than Friday October 2, 2015. Please see attached forms. Each charter will select one student to nominate. Multi-district
charters may nominate two students. All Region XV nominees will be recognized at Region XV’s Every Student Succeeding Award
Ceremony on Thursday, November 12, 2015, at the American Legion Building in Pasadena from 9:30 a.m. to 11:30 a.m. Every
nomination may be considered for the Region ESS Award. Please complete attached nomination form thoroughly and with
care. The Region ESS winner is honored at Region XV’s Spring Awards Banquet and at ACSA's Annual State Leadership
Conference in November. Don’t delay your nomination!
EVERY STUDENT SUCCEEDING
RECOGNITION PROGRAM
2015-2016
Based upon the success of the “Every Student Succeeding” recognition program, ACSA’s State Board of Directors
adopted is a continuing part of ACSA’s annual awards program.
Purpose: These awards recognize public school success by honoring one student from each of the 18 regions the
association serves.
Eligibility: Students who achieve despite struggles, barriers, or challenges and the educator and education supports who
helped these students succeed.
Nomination Process: Nominations for ACSA Student and Support Team Recognition are submitted on the Nomination
Form of ACSA Every Student Succeeding Recognition along with two essays and student photo to the ACSA Region
VP Programs.
Essays of no more than 1 page each respond to:
o
o
Why did you select this student? Tell us their success story in such a way that we get to know the
individual and the team that supported them.
Describe the policies, practices or programs, which contributed to their success.
Each region makes its decisions on how to select one student nominee to be submitted to State ACSA. The region can
choose to use a Region Awards Committee, solicit names through Charter Presidents and ask Committee Chair for
nomination. The State ACSA Conference Committee confirms the 19 students.
Deadlines:
ESS Nominations Due: Friday, October 2, 2015 to
Rebecca Summers, Region XV VP Programs
rsummers@glendora.k12.ca.us
RSVP for the ESS Awards Ceremony Due: Friday October 23, 2015 to
Mike Seaton, Region XV Consultant
regionXVconsultant@acsa.org
Questions? Please Contact:
Rebecca Summers
Office (626) 963-1611 ext. 327
Fax (626) 852-4581
rsummers@glendora.k12.ca.us
Where/When Recognized: Charter nominees and the Region honoree will be recognized at the Region XV
Every Student Succeeding Award Ceremony on Thursday, November 12, 2015. Charter nominees must
attend the ceremony to receive their award or there may be an exception approved by ACSA Region XV Board
of Directors for an absence from the event. The Region honoree will also be honored at the Region XV Spring
Conference and Awards Dinner on Wednesday, April 27, 2016. Region honoree will be recognized at
ACSA’s Annual Leadership Summit Conference in November.
2015-2016
ACSA Every Student Succeeding
Recognition
Nomination Form
Student’s Information:
Name: ______________________________________
Graduation Date: _________
Gender:____
Current Grade: _______
Ethnicity: ________
School:_______________________________________________________________________
District: ______________________________________________________________________
Address: _____________________________________________________________________
Phone: _________________________ Fax: ________________________
Last 4 Digits of Social Security Number: _______________________ (Required for Honorarium)
Essay (Required)
Please respond to the following questions (no more than 1 page each):
•Why did you select this student? Tell us his or her success story in such a way that we get to know him or her.
•Describe the policies, practices or programs that contributed to his or her success.
Nominees should be students who have made a special effort to succeed and have overcome obstacles such as:
•Returning to school
•Leaving a gang
•Improving their attendance
•Changing their attitude
•Overcoming physical and mental barriers
They should also be active in:
•After-school programs
•Student conflict resolution
•Peer mediation
•Community service
•Cross-age tutoring
•Peer tutoring
Nominees can come from programs such as:
•Alternative Education
•At-risk
•Bilingual/ELD
•Continuation School
•K-Adult Programs
•Pregnant Minors
•GATE
•Migrant
•Special Education
•Vocational Education
•Homeless
Person submitting the nomination:
Name: _________________________________ Title/Site: ___________________________
School District:__________________________________ Charter: _____________________
Work Phone: ___________
Email: ____________
Fax: ______________
Team (up to 5) that supported the student
and enabled him or her to succeed:
(1) Name:_______________________________ Position: _____________________________
School: _______________________________________________________________________
District: ______________________________________________________________________
Address: _____________________________________________________________________
Phone: ________________________________ Fax: _____________________
(2)Name: _________________________________ Position: ___________________________
School: _______________________________________________________________________
District: ______________________________________________________________________
Address: _____________________________________________________________________
Phone: ________________________________ Fax: _____________________
(3)Name: _________________________________ Position: ___________________________
School: _______________________________________________________________________
District: ______________________________________________________________________
Address: _____________________________________________________________________
Phone: ________________________________ Fax: _____________________
(4)Name: _________________________________ Position: __________________________
School: _______________________________________________________________________
District: ______________________________________________________________________
Address: _____________________________________________________________________
Phone: ________________________________ Fax: _____________________
(5)Name: _________________________________ Position: ___________________________
School: _______________________________________________________________________
District: ______________________________________________________________________
Address: _____________________________________________________________________
Phone: ________________________________ Fax: _____________________
ACSA Region XV
Every Student Succeeding
Recognition Program
2015-2016
Every Student Succeeding
Ceremony & Reception
Pasadena American Legion
Thursday, November 12, 2015
9:30 a.m. – 11:30 A.m.
Light Refreshments Served
Ceremony RSVP Due October 23, 2015
Each recipient may bring up to 8 guests, including family and school representatives.
Name of Guest
Charter
RSVP due Friday October 23, 2015
Return this registration form to:
Mike Seaton
737 N. Lamer Street • Burbank 91506
Email: RegionXVconsultant@acsa.org
Fax 818.846.5824
District