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					                                        Professional Development Record Form 2011-2012
                                          Public Schools of Petoskey – Elementary Level
   Employee Name:                                                                            Building:

   Source                                               Date     Title or Content of Professional Development Activity   Number     TOTAL
                                                                                                                         of Hours   HOURS
1. 1. Sustained, work-embedded, focused on             9/6/11    District PLC -                                             6
   teacher growth, directly related to student
   achievement.
   This category must include activities that          10/7/11   District PLC – Grades K-3                                  3
   focus on the work that educators do and                                OR
   related to the learning of students in the
   school district.                                    10/7/11   District PLC – Grades 4-5                                  6
   NOTE: Must include narrative.
                                                       11/2/11   District PLC -                                             6


                                                       1/20/12   District PLC -                                             3


                                                       2/17/12   District PLC -                                             3


                                                       5/25/12   District PLC -                                             3




   2. Mentoring and being mentored.
   NOTE: This does not included student teachers and
   teacher assistants.
   The number of hours of professional
   development acquired for the purpose of
   advancing mentoring skills or advancing
   classroom skills of a new teacher during
   his/her first three years in the profession.
   3. Workshops, or Conferences
   The number of hours of participation in one-
   day or short-term professional development
   provided by LEAs, ISDs, higher education
   institutions, regional Math/Science Centers,
   professional organizations, etc.




   Revised 2011
                                                                          Page 1 of 2
                                  Professional Development Record Form 2011-2012
                                    Public Schools of Petoskey – Elementary Level
Source                                           Date   Title or Content of Professional Development Activity        Number      TOTAL
                                                                                                                     of Hours    HOURS
4. Coursework
The number of hours of professional
development acquired through continuing
education courses taken for semester credit at
a college or university.
NOTE: Number of hours, not credits.

5. Highly Qualified Status.
The number of hours of content-specific
professional development acquired for the
purpose of documenting Highly Qualified
status.
NOTE: This category will not apply to
many staff members.

6. State-level or institution of higher
education content-specific service or
committee.
The number of hours of professional
development acquired through state-level or
institution of higher education content-
specific service or committee.

7. Virtual learning.
The number of hours of content-specific
professional development acquired through
online delivery or other distance-learning
experiences.




Employee’s Signature: _______________________________________________________________ Date: _____________________________________


Principal’s Signature: ________________________________________________________________ Date: _____________________________________




Revised 2011
                                                               Page 2 of 2

				
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