DMA(EXHIBIT) - PROFESSIONAL DEVELOPMENT: REQUIRED STAFF DEVELOPMENT

REQUEST FOR PRIOR APPROVAL OF NON-DISTRICT SPONSOREDPROFESSIONAL LEARNING HOURS

PERSONAL INFORMATION:

Name: _______________________________Social Security #: _______________

School: _______________________________ Subject/Grade: ________________

WORKSHOP INFORMATION (needs principal approval only):

The workshop portion of this form must be completed and approved by the Principal prior to teacher participation in workshops in order for the hours to count toward the 50 hours required of teachers to be considered for a pay increase.

This form need not be completed for District-sponsored workshops or for approved school-based workshops provided the workshops you attend were designed for teachers in your content area/field.

Title of Workshop: ________________________________________________________

(attach description, if available)

Date(s) of Workshop: _____________________________________________________

Location: _________________________ Time(s) of Workshop: _________________

Total Hours Requested: _______ Number of GT Hours Requested: _________

Sponsor: _______________________________________________________________

Principal's Signature: _____________________________________________________

COLLEGE COURSEWORK: The college coursework portion of this form must be completed and approved by the Principal prior to enrolling in college courses in order for professional learning hours to be considered.

Title of Course:

Number of Coursework Hours:

Semester (Fall/Spring/Summer): Year:

College/University:

Seeking Certification or Endorsement? If so, specify:

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STAFF LEARNING APPROVAL: ________ Yes _________ No

Signature — PrincipalDate

This form is only to be used for requesting Professional Learning hours. The "Workshop Information" and "College Coursework" boxes (above) require principal approval.

Spring ISD

DMA(EXHIBIT)-X

LDU 2013.07

DATE ISSUED: 8/30/2013