Waconia Public Schools - ISD 110 Request for CEU

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If you are attending a workshop outside of the district, please use this form to request CEUs prior to attending the workshop. You will receive email notification of approval or denial of your request. If approved, submit your Certificate of Attendance after completion of the workshop to Erika Nesvig via email: enesvig@isd110.org. Once received, Erika will email your signed CEU.

Aligned with 2021 PELSB recertification requirements

Name of Participant *

Title of Workshop *

Workshop Sponsor *

Date of Workshop *

YYYY

Professional Development Course Description (Include learning objectives) *

Number of Clock Hours (excluding lunch and/or dinner) *

Category (see below for licensure category descriptions) *

Mandatory Renewal Requirements (check one) *

Positive behavior intervention strategies (PBIS)

Accommodations and modifications for diverse learners

Reading preparation and instruction (requirement for renewal in 2024 and beyond)

Suicide prevention (1 hour minimum)

Key warning signs for early onset mental illness in children and adolescents

Best teaching practices for EL Learners - Currently met through the D110 PGRE Plan

Cultural Competency - Foundational training (minimum of 2.5 hours) - Self-reflection, awareness of, and discussion related to the following: Basic Terminology, Systemic Racism (Racial, Cultural, and Socioeconomic Groups), Unconscious Bias, Understanding the Achievement Gap

Cultural Competency - Recognizing diverse populations (minimum of 2.5 hours) - Self-reflection, awareness of, and discussion related to the following: Non-dominant Cultural Groups (Including American Indian and Alaskan Native), Religion, Sexual Orientation and Gender Identity, Language Diversity, Individuals with Disabilities

Required

Licensure Categories

A Accredited college or university coursework (16 hrs/qtr credit, 24 hrs/semester credit)

B Workshops, conferences, institutes, seminars, or lectures in areas appropriate to licenses held

C Staff development activity, inservice, professional learning communities, child study

D Curriculum development

E Engagement in formal peer coaching or mentorship experiences

F Professional service in the following areas: Clinical experience supervision of persons enrolled in teacher preparation programs (16 clock hrs/quarter or 24/semester - maximum of 30); Licensure, teacher education, or professional standards committee; Accreditation committee

G. Leadership experience or volunteer work in a professional organization: Development of new or broader skills and sensitivities to the school, community, or profession; Publication of professional articles in a professional journal in an appropriate field; volunteer work in professional organizations related to the areas of licensure held

H Opportunities to enhance knowledge and understanding of diverse educational settings in the following areas: Experiences with students of another age, ability, culture, or socioeconomic level; Systematic, purposeful observation during visits to schools and to related business and industry

I Pre-approved travel or work experience related to field of licensure

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