Future Reflections                                                                                         Winter/Spring 2005

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National Federation of the Blind Distinguished Educator of Blind Children Award
2005 Application

Deadline: May 15, 2005

Name:_______________________________________________________________������������

Home address:_________________________________________________________������������

City, State, Zip:_________________________________________________________

Phone: (H)____________________________________________________________
          
(W)____________________________________________________________
          
(C)_____________________________________________________________

Email:_________________________________________________________________

School:________________________________________________________________

Address:_______________________________________________________________

City, State, Zip:__________________________________________________________

Use a separate sheet of paper and answer the following:

� List your degrees, the institutions from which they were received, and your major area or areas of study.

� How long and in what programs have you worked with blind children?

� In what setting do you currently work?

� Briefly describe your current job and teaching responsibilities.

� Describe your current caseload, e.g., number of students, ages, multiple disabilities, number of Braille-reading students, etc.

Attach the three required letters to this application and send all material by May 15, 2005, to:

Sharon Maneki, Chairwoman, Teacher Award Committee, 9013 Nelson Way, Columbia, Maryland 21045-5148, <[email protected]>, (410) 715-9596.

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