Application form for granting the Faculty of Arts of Masaryk University Dean’s Award for Outstanding Educational Activity Applicant First name, surname (including academic degrees) Contact details (e-mail) Proposed person(s) Name, surname (including academic degrees) Contact details (e-mail) Justification for submitting a proposal for an award Verbal justification of the application (Brief description of the pedagogical activity of the proposed person with an emphasis on description of innovations within the subjects taught, non-traditional didactic procedures, teaching support, etc., which makes the pedagogical activity of the proposed person exceptional) Examples of feedback from the course opinion poll, which illustrate the justification of the application for the Award Statement of the evaluation board Recommended for being awarded. Not recommended for being awarded. Reasons for rejecting the application: Date Name of the chair of the board Signature