Professional
Learning Program
Application
for Professional Learning Unit Credit
Prior
Approval Form
Participant’s
Name: _________ ____
_
Home
Address:
School System:
Certification
Type: Position:
Date
of Birth: Social Security #:
Name of Course: _________________________________________________________
Check
the categories for which this PLU credit applies:
|
q
Field(s) of Certification |
q
School/System/Individual Improvement Plan |
|
q
Annual Personnel Evaluation |
q
State/Federal Requirements |
Description of Course:
Location of Course:
Dates of Course:
I hereby approve this person’s participation in the above
named Professional Learning Unit Credit Program. I further certify that the goals and objectives of this course
are consistent with the goals and improvement objectives of this school system.
System Superintendent
or Date of Approval
Professional Learning
Coordinator
I’m not employed in a public or private school.
|
|
|
____________________________________ |
______________________________ |
|
Signature of Participant |
Date of Approval |