JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
UAB Technology In Motion PD (Request Region 5)
Please complete this form as it is vital when planning for effective professional development. Our training sessions are tailored to the specific needs and/or goals that are explicitly outlined by you or your school. Due to obligations or prior commitments, not all dates can be honored. Please note that fields marked with an asterisk (*) are required.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
First and Last Name of person requesting support
*
Your answer
Email Address
*
Your answer
Contact Number
*
Number is needed in case of an emergency
Your answer
District
*
Please select your school system/district
Choose
Bessemer City
Birmingham City
Fairfield City
I3 Academy
Jefferson County
Leeds City
Legacy Prep
Magic City Acceptance Academy
Midfield City
Tarrant City
Trussville City
School Name
*
Your answer
School / Site Address (for driving/map purposes)
*
Your answer
What is your role in the school/organization?
*
Choose
Assistant Principal
Curriculum Specialist
District Administrator
Librarian
Principal
Reading Coach
Superintendent
Technology Coordinator
Other
Intended grade level
*
PreK
K - 2nd
3rd - 5th
6th - 8th
9th - 12th
Other
Required
Want training on.....
*
Example: (Google Classroom, Schoology, Nearpod, Google Certification, Coding, Digital Discipline Forms, etc).
Canva
Choice Boards
Chrome Extensions
Coding and Robotics
Computer Science in the PreK Classroom
Discipline w/ Google Forms
EdTech Tools
Google Educator Level I
Google Educator Level 2
Implementing Computer Science Across the Curriculum
Jamboard
Nearpod
PowerSchool SIS
Schoology
Swift Playground Learn to Code 1
TeacherMade
Other:
Training Session Length
*
1/2 hr - 1 1/2 hr (after school)
1/2 day (Subs and schedule provided by school)
Full Day (Subs and schedule provided by school)
Half Day (Professional Development day; no subs needed)
Full Day (Professional Development day; no subs needed)
Grade Level/Department Planning Times (all day) *Send schedule
Summer PD at my school
Other:
Session will be delivered
*
In Person (Face-to-Face)
Virtual Via Zoom
Other:
What date & time would you prefer? (First Choice)
*
MM
/
DD
/
YYYY
Time
:
AM
PM
What date & time would you prefer? (Second Choice)
*
MM
/
DD
/
YYYY
Time
:
AM
PM
Will the room have a projector, screen, and speakers?
*
YES
NO (Specialist will need to bring own equipment)
Which device will most attendees be using?
*
Apple MacBook / iPad
Chromebook
Windows PC / Laptop
Variety
None
Any Comments, Questions or Concerns
Your answer
You may also call me to schedule dates. 205-202-0409. Even if you call, please also fill out this form for my records.
*
I understand if I call, I also need to fill out this form.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
