TEACHING ACADEMY NOMINATION COVER PAGE
2015
Deadline: 5:00 PM Friday April 3rd, 2015
Must be submitted electronically to CIE (CIE@purdue.edu)
Nominee's Name:
Rank:
Department, College/School, or Program:
Nominee’s campus mailing address:
Nominee’s campus or cell phone:
Date Purdue University Service Began:
Nominated for (please check one)
Fellow
Associate (graduate students, lecturers, or
instructors)
Description of Department, College/School, or Program nominee selection process with
evidence of peer review. NOTE: This is NOT a recommendation letter; the content of this
cover page will NOT be considered during the selection process.
Dean's Name:
Dean’s campus mailing address:
Dean’s contact phone number:
Dean's Signature: (may be electronic signature)
Nominee Name: __________________________
Page 1
(What follows is the recommend template for a Teaching Academy Nomination.)
(Items that are highlighted in yellow and found in parenthesis are intended to provide guidance in
developing the nomination and should be deleted from the final nomination form. Likewise,
you may add or delete pieces of evidence as you see fit. Sections containing bullets may be
converted to a paragraph format if a logical reason exists for doing so. Please note that the
maximum length of the document is five (5) pages.)
1. Teaching/Education Philosophy and Goals
(This section should describe your philosophy and goals in paragraph form. The Academy makes
a distinction between these two. A teaching/educational philosophy describes what you believe
about teaching, learning, students, and instructors, and how these four items interact.
Teaching/educational goals are outcomes you would like your students to achieve. While these
two items should relate to each other, they are not the same. References to the literature on teaching
and learning are encouraged.)
2. Teaching Activities
(This section should describe the specific course or courses you have taught in the previous four
(4) years, with an emphasis on those taught more recently. The third table below provides a
template for how scores should be presented.)
Table 1. Courses Taught
Sem
Course Number
(Credit Hours)
Course Title
Required or
Elective?
Enrollment
Mode Of
Instruction
Contact
(hrs/wk)
Fall
2013
ENGL 41200
(1)
American Women Poets
Elective
35
Lecture
3
Table 2. Engagement Programs
Dates
Program Title & Brief Description
Intended Audience
July
2012
Creative writing workshop for middle school
middle school
teachers
Enrollment
Participant
Contact Hrs
25
6
Table 3. Course Evaluations (Scores on a 1-5 point scale with 5 being highest)
Sem
Course Number
# Responses/
# Enrolled
Fall 2013
ENGL 41200
31/35
Nominees Course
Evaluation Score
4.57
Nominees Instructor
Evaluation Score
4.08
Nominee Name: __________________________
Page 2
Student Comments regarding evaluations
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Table 4. Teaching Awards
Award
Award Sponsor
Level of Award
Year
(Department, College/School,
University, Professional
Society)
Teaching for Tomorrow
Award
Purdue University
University
2009
3. Teaching Innovations
Course/Program/Curricular Creation or Innovation:
(Examples may include the attainment of a teaching innovation grant, successful integration of
multimedia instruction and technology to enhance student learning, etc.)
Instructional or Curricular Problem Solved:
(Description of an instructional or curricular problem that the nominee solved and how the body
of knowledge on teaching and learning was used as a vehicle for solving the problem. This might
include a description of how the problem was identified, what process/method the nominee took
to address the problem, and the evaluation of its impact.
These two sections may be combined, as the solution to a curricular problem may have been to
create a new course.)
4. Teaching Service
Student Contact Outside of Classroom:
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(E.g., academic advising, graduate committees, advising a student organization, supervising of
undergraduate research, etc.)
School/College or University Committees related to Education and Teaching:
Nominee Name: __________________________
Page 3
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Professional Activities Related to Education and Teaching Outside the University:
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E.g. participation on an education committee for a professional society.
5. Scholarship of Teaching and Learning
(This section should demonstrate the nominee’s commitment to the Scholarship of Teaching and
Learning. The Academy makes a distinction between “Scholarship” related to your area of
research expertise and “Scholarship of Teaching and Learning”. While both involve research,
analysis, and publication or presentation, the Scholarship of Teaching and Learning focuses on the
nominees publications and presentations on teaching activity, pedagogy, student learning, etc.
Please provide only scholarly evidence related to teaching and learning.)
Peer-Reviewed Journal Articles:
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Peer-Reviewed Conference Papers:
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Text Books/Book Chapters on Pedagogy:
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Invited Presentations:
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Poster-Sessions:
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End of Nomination Form