Professional Conference Model Application
PLEASE NOTE:
1.) Please read the Professional Conference Model Guidelines - http://svvsd.org/files/Professional-Conference-Model-Guidelines.docx - before filling out this application. These instructions are also located under "Professional Development Models" on the Professional Development website.
2.) This application must be submitted to the Office of Professional Development for written approval a minimum of THREE WEEKS prior to the conference. This time frame will allow for modification, if needed.
3.) The application must be aligned with both district and school improvement goals.
Conference Title *
Your answer
Conference participant name or team contact name *
Your answer
Link to Conference *
Copy-paste the URL for the conference home page below.
Your answer
School or District Department *
Your answer
E-Mail *
Your answer
Beginning Date of Conference *
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DD
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YYYY
Ending Date of Conference *
MM
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DD
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YYYY
Credit
Please choose one.
Credit and Participant Fees *
For licensed staff, one-half (.5) semester hour of credit is equal to 7.5 contact hours. One semester hour of credit is equal to a minimum of 15 contact hours. Choose semester hours/class fees from the list below.
Type of Credit *
Collaboration
List the names of staff you have consulted with to assure alignment with school and district improvement goals and indicate clearly the extent of their involvement. *
Before registering for this conference, you must consult with appropriate building and district staff as advisors to assure alignment with school and district improvement goals. Be sure to include your building principal as one of your contacts.
Your answer
Data/Background Information
What data/background information did you use to help you determine the need to attend this conference? *
Your answer
What do you anticipate learning at this conference? *
Your answer
How do you anticipate using these learning to improve professional practice and/or increase student achievement? *
Your answer
How will you share your learning and the information from the conference with your colleagues? *
Your answer
Please identify the sessions you plan to attend. *
Your answer
Summary Product
Within three weeks following the conference, please submit:
* Individual Reflection (guiding questions can be found in the Professional Conference Guidelines (http://svvsd.org/files/Professional-Conference-Model-Guidelines.docx)
* Individual or team summary product, including a guide/explanation of the product
* Conference Note Taking Log (http://svvsd.org/files/Conference-Note-Taking-Log.docx)
* Check made out to SVVSD or cash for the credit fee
Describe the product that will be evidence of your learning. Be sure the summary product aligns with your data and goals. The summary product must be a concrete product that will be submitted to the Office of Professional Development upon completion. *
Your answer
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