PD Request Form

	B	C	E	F	G	H	I	J
1
2	Professional Development Activity Request
3	You must attach a Authorized Leave Form (available from your school) to this document Please make a copy of the completed form for your records (all other forms are available on the PD website)
4
5			Activity Request submitted by:
6	Activity aligns with:
7		District CSIP Goal:
8		Building SIP Goal:
9	Activity Focus Area(s):
10		Area 1:
11		Area 2:
12		Area 3:
13	Funding Source(s): mark each source you are requesting funds from with an “X” .			Approval Signature (Both the PD rep and principal must sign)
14		Building
15		Department
16		Bldg Principal
17		Special Projects (Dist. PD funds)
18	Professional Development Activity Description
19		List name of activity and briefly describe:
20
21
22	Location of activity:					Date of activity:
23
24	Participants Names:
25	A separate form needs to be filled out for each participant.
26
27	Activity Cost Calclulation:						Grand Total	$0.00
28		Substitute Cost:	# of subs	#of days	Sub Pay	Total
29					$130	$0.00
30		Staff Compensation:	# of subs	#of days	Pay
31					$25	$0.00
32		Purchased Services:	Airfare
33			Registration*				Travel Request/Reimbursement Form
34			Lodging**				Travel Request/Reimbursement Form
35			Consultant Fee				Consultant Form
36		Materials/Supplies:			Materials		Request for Materials Form
37	* Please include copy of registration Travel Request/Reimbursement Form **You will need to make your own hotel reservations. You will need to fill out all forms associated with each line item.
38	Criteria for High-Quality Professional Development (Mark each description below with an “X” that applies to the requested activity)
39	Part I: High-quality professional development:
40			actively engages teachers, over time.
41			is directly linked to improved student learning so that all children may meet the Show-Me Standards at the proficient level.
42			is directly linked to district and building school improvement plans.
43			is developed with extensive participation of teachers, parents, principals, and other administrators. [*Parent participation may be at the CSIP level]
44			provides time and other resources for learning, practice, and follow-up.
45			is supported by district and building leadership.
46			provides teachers with the opportunity to give the district feedback on the effectiveness of participation in this professional development activity.
47	Part II: Some types of activities that might be considered high-quality professional development if they meet the above requirements are:
48			study groups.
49			grade-level collaboration and work.
50			content-area collaboration and work.
51			specialization-area collaboration and work.
52			action research and sharing of findings.
53			modeling.
54			peer coaching.
55			vertical teaming.
56			other:
57	Part III: Topics for high-quality professional development may include:
58			content knowledge related to standards and classroom instruction.
59			instructional strategies related to content being taught in the classroom.
60			improving classroom management skills.
61			a combination of content knowledge and content-specific teaching skills.
62			the integration of academic and vocational education.
63			research-based instructional strategies.
64			strategies to assist teachers in providing instruction to children with limited English proficiency to improve their language and academic skills.
65			strategies to assist teachers in creating and using classroom assessments.
66			instruction in the use of data to inform classroom practice.
67			instruction in methods of teaching children with special needs.
68			instruction in linking secondary and post-secondary education.
69			involving families and other stakeholders in improving the learning of all students.
70			strategies for integrating technology into instruction.
71			research and strategies for the education and care of preschool children.
72			research and strategies for closing achievement gaps between diverse groups of students.
73			other:
74	Provide a plan for sharing information or skills learned from this activity.
75
76
77	Activity Permissions (PD Committee use only)
78			approved				building funds
79			not approved				special projects
80
81		Building Name:				Date:
82