APPROVAL FOR COURSEWORK TO BE USED FOR SALARY ADVANCEMENT
Use this form for university credits and out of district seminars/workshops.
Name Employee ID # Work Site
Current Assignment Date Submitted
Activity (Please check one):
Graduate Course (Please forward approval form to Human Resources.)
If course is part of an approved program of study, approval not necessary.
Undergraduate Course (Please forward approval form to Human Resources.)
CERTIFIED: Request should include course description, anticipated need in the district and recommendation from immediate
SUPPORT STAFF: Request should include course description. Courses within approved degree program are eligible for approval.
Please forward a copy of your program of study for your file.
Seminar/Workshop (Maximum 7 points per day, 30 points per year for District credit and Certificate Renewal.)
(Please forward approval form to Professional Growth Department. Request should include documentation (letter,
brochure, pamphlet, etc.) describing activity. Approval by the Director of Professional Growth required four weeks in
advance. Online courses and/or conferences are not accepted for District or Career Ladder credit.
Title of course or workshop with Course Number:
Name of university or organization:
Schedule of Meeting Times Dates: Times:
Number of classroom contact hours: Number of credits requested:
Number of university credits (or points) requested:
As per university and district standards, 15 classroom contact hours = 1 university semester hour.
*Credit for university courses will be awarded according to the following:
15 – 29 scheduled classroom hours = 1 semester hour of credit
30 – 44 scheduled classroom hours = 2 semester hours of credit
45 hours = 3 semester hours of credit
*In-district credit for out of district seminars/workshops will be awarded credit according to a point system (1classroom
hour = 1 point)
My signature indicates my understanding that credit for salary advancement is allowable if: 1) the activity
occurs outside of my regular contract time and 2) payment is not received from district/school/Career Ladder
funds, or 3) I am not receiving Career Ladder credit, OR
This request is for Career Ladder credit
Required for in-district credit:
Employee Signature Date Syllabus/Agenda
Principal/Immediate Supervisor Date
Approved Not Approved Need more information
Note: Any course approved on this form will also meet the criteria for certificate renewal.
Director of Human Resources Date Director of Professional Growth Date
Professional Development Office use only Revised 07/20/07
Payment Due______ Date Received______ Number of Credits Approved_______ Cert/Trans received_____