SW SELPA PD On-the-Go Request Form

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Thank you for your interest in the Southwest Special Education Local Plan Area (SW SELPA) in-service training for your district. Please complete all the questions below and submit the form 60 days prior to the requested training date. Only completed forms will be processed. The contact person you provide will receive a confirmation email from Vanessa Smith, at Vanessa_Smith@swselpa.org, with the details and the next steps for the training.

Date Today *

YYYY

Your Name *

Your Title/Position *

Your Email Address *

School District *

Did you get prior approval from your Sp. Ed. Director/Administrator? *

NOTE: Your director/administrator will be notified about this request.

If you are not the Contact Person for this request, please provide the Name, Email Address, & Phone Number of that person (type NA for not applicable). *

NOTE: Please make sure that the email address and phone number are accurate. This person will be contacted about the status and the details of the approved request.

Date of Training *

NOTE: We will try our best to look for a presenter on your preferred date. However, please also include alternative date(s) in case the presenter is not available on the date you prefer.

Time of Training *

NOTE: Please include training duration (i.e., 8:00am-3:30pm).

Training Format *

If you answered "In-Person Training," please provide the complete address of the venue (type NA for not applicable). *

NOTE: Please include the specific building (i.e., Multi-Purpose Hall of Kit Carson Elem. School)

Training Topic *

Alternative Dispute Resolution

Behavior Intervention Plans (BIPs)

Conflict Coaching: Effective Communication for the Classroom Team

Disability Specific Training

Dyslexia/Reading Strategies and Supports

Executive Functioning

Facilitated I.E.P. Meetings

Functional Behavior Assessments (FBA)

Inclusive Practices

Manifestation Determination

Mental Health Supports and Strategies

Parent Training

Positive Behavior Supports and Strategies

Progress Monitoring

SEIS Training

Surrogate Training

Threat Assessments

Universal Design for Learning

Other:

Required

Are there other details about the training topic and/or content that you would like to share? (If not, type None.) *

Estimated Number of Attendees *

Type of Audience *

NOTE: Please select all that applies.

Administrators

Paraprofessionals/Para-educators

Special Education Teachers

General Education Teachers

School Psychologists

School Counselors

Program Specialists/Coordinators

Site Administrators

Related Service Providers

Behavioral Specialists/Technicians

Other:

Required

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