DMA(EXHIBIT) - PROFESSIONAL DEVELOPMENT: REQUIRED STAFF DEVELOPMENT
REQUEST FOR PRIOR APPROVAL OF NON-DISTRICT SPONSOREDPROFESSIONAL LEARNING HOURS
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: _________
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:
Seeking Certification or Endorsement? If so, specify:
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.