VPI Coordinator Teacher Enrollment Form
Please make sure to read the following before beginning the enrollment process.

• The teacher identified as 'Selected VPI Teacher' is recommended for the guaranteed course slot for our school division.

• The teacher identified as 'Alternate VPI Teacher' is recommended if there is an additional opening(s) in a course. I understand that these slots will be filled on a first-come, first-served basis according to the date this enrollment form was received at UVA. The sooner a completed form is submitted, the more likely that alternate teachers may be enrolled in the course.

• UVA will contact the teachers informing them of 1) their acceptance to a course and 2) to which course they have been selected. UVA will also outline clear instructions for teachers to follow in order to enroll in the course.

• Teachers must have and be able to use the technology as outlined in the ECI Courses - Effective Classroom Interactions page on the VPI+ website.

• I understand that the course is a non-credit course and is being offered for professional development. The school division may award licensure renewal points based on the VDOE Licensure Renewal Manual guidelines.

Employing 2018-2019 School Division *
Your answer
Last Name *
Your answer
First Name *
Your answer
Middle Name
Your answer
Email Address *
Your answer
Phone Number (include area code) *
Your answer
Name of Selected VPI Teacher *
Your answer
Email of Selected VPI Teacher *
Your answer
Name of Alternate VPI Teacher
Your answer
Email of Alternate VPI Teacher
Your answer
If you have any questions, please write them here.
Your answer
Initials *
By my initials, I am indicating recommendation of the above-named individual(s) to take a UVA online early childhood course being offered through this professional development opportunity, and I have discussed the nomination(s) with these individual(s).
Your answer
Today's Date *
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