OPSRC Professional Development Request Form
OPSRC requests this information to prepare for your professional development. If your preferred date is unavailable, a member from the Teaching and Learning team will be in touch with alternate dates and times.
Email address
District Name
Your answer
School Name
Your answer
Name of Contact (First and Last)
Your answer
Alternate E-Mail Address
Your answer
Position/ Title of Contact
Your answer
Cell Phone Number for Contact
Your answer
PD Topics Requested (Descriptions of sessions available in the 2017-2018 PD Catalog)
If you are requesting more than 1 topic covered at Professional Development, please add that in the "notes/additional information" section at the bottom of the form.
Date PD Requested (Specify dates if more than one date needed)
Your answer
Time PD Requested (ex: 8:30-11:30am)
Your answer
Location of PD (include name and physical location as well as any special directions for accessing the building, parking, etc.)
Your answer
Expected Number of Participants
Your answer
Type of Room Setup
Type of Internet available
Notes or Additional Information
Your answer
Submit
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