Fall 2020 SY Brevard PDC Application and Program Participant Survey 19-20
Please complete the survey below.
Email address *
Validation Statement
I understand, as a participant in the BPS PDCP, I will be required to comply with all program requirements and conditions, as well as being subject to all terms and conditions of employment in Brevard Public Schools contained in the School Board of Brevard County/Brevard Federation of Teachers Contract, state statutes, and board rules. I understand successful completion of the PDCP is contingent on meeting all program requirement, including successful completion of all required professional development components, FTC exams and submission of a completed PDCP portfolio. Typing your name below substitutes as a valid signature of agreement.
Validation Statement Signature (type name) *
Your answer
First Name *
Your answer
Last Name *
Your answer
Employee ID # *
Your answer
Race *
Required
Hispanic or Latino (Ethnicity) *
Home email address *
Your answer
Home/Cell phone number (best contact outside of business hours) *
Your answer
Work Phone (include extension) *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Work Location (School) *
Your answer
School Principal's Name (First, Last) *
Your answer
What grade level do you teach? *
What subject do you teach? *
Your answer
Next
Never submit passwords through Google Forms.
This form was created inside of Brevard Public Schools. Report Abuse