Workshop Proposal Form for Board Approved MHTC Presenters 2019-20
This form is to be used by those who have been approved by the Mid-Hudson teacher Center Policy Board. If you have not yet been approved please use the "Workshop Proposal Form for those Seeking to be Approved MHTC Presenters" If you have multiple ideas for proposals, please complete a separate form for each workshop topic.
Presenter/Facilitator's Name *
Your answer
Address *
Your answer
City, State and Zip Code *
Your answer
Telephone Number (cell/home or both) *
Your answer
Email Address *
Your answer
Workshop Title *
Your answer
Description of the workshop, include specifics about what the participants will know and be able to do as a result of this learning experience. Also describe the activities that will take place including what participants will create during the workshop (a lesson plan, inventory of resources etc.) *
PLEASE NOTE:This information is intended to communicate what is required of attendees so that they are prepared to participate, and complete activities required to receive credit. This is particularly important with regard to the synchronous Zoom workshops where attendees will need access to a device with fully functioning camera and microphone, as well as the ability to access websites and resources like Google Apps.
Your answer
Category / Topic *
Choose One or two
Standard *
Choose One
Available Dates for Workshop *
We may be able to run the workshop more than once, so you can propose more than one set of dates. For example, mid-late Sept., then again in November.
Your answer
Time and duration of workshop *
If at a location, then indicate when can you arrive at the location. If this is a synchronous Zoom workshop, then we have generally run them either from 4-6pm or 7-9pm. You may propose other times and durations as well.
Your answer
Suggested Location(s) for workshop. Specify if it is to be conducted as synchronous (live) online, at a particular location, or a combination of both (hybrid). *
Your answer
Equipment needed for workshop. Specify for students and for instructor. *
A workshop at a location might need wireless internet, SmartBoard, Projector, etc.
Your answer
Maximum Number of Participants (we generally cap the online synchronous at 15 because we want them to be interactive and participatory) *
Your answer
Audience *
example: teachers, special education teachers
Your answer
Grade Level *
Example: K-3, Pre K-6, High School
Your answer
Total number of contact hours. *
Students and Learning -Please check the CCLS that will be covered at the workshop
There can be more than one CCLS
Content and Instructional Planning-Please check the CCLS that will be covered at the workshop
There can be more than one CCLS
Instructional Practice-Please check the CCLS that will be covered at the workshop
There can be more than one CCLS
Learning Environment-Please check the CCLS that will be covered at the workshop
There can be more than one CCLS
Assessment for Student Learning-Please check the CCLS that will be covered at the workshop
There can be more than one CCLS
Professional Responsibilities and Collaboration-Please check the CCLS that will be covered at the workshop
There can be more than one CCLS
Professional Growth-Please check the CCLS that will be covered at the workshop
There can be more than one CCLS
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service