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CTCOLT Fall Conf. '08 - CEU P.D.A. FORM

The Professional Development Activity Form is REQUIRED by the State of CT in order for CT COLT to be able to grant CEUs to those attending a workshop.

Your Workshop Proposal MUST BE SUBMITTED by May 30th, 2008.

NAME OF APPROVED PROVIDER:
Connecticut Council of Language Teachers,
Annual Fall Conference, Monday, October 27th, 2008

Workshop Proposal I.D. *

MAKE SURE to type in the SAME Workshop Proposal I.D. You used before on the Workshop Proposal Form. FIRST 3 letters of your LAST name, followed by the LAST 4 digits of your PHONE number. Example: dem9238
Please PROVIDE this SAME I.D. to your Co-Presenter(s) who MUST use this SAME I.D. in order to complete the REQUIRED R?ɬ�sum?ɬ� form.
Your email address *

Please use the same email address you used before on the Workshop Proposal Form, as the Main Presenter's email address. Thank you!
Title of Activity (Workshop Title) *
Name(s) of Presenter(s): *
Need(s) to be addressed (by the Workshop) *
How was this need identified? (Please check all that apply.) * Goals / Objectives Anticipated / Felt / Perceived Factual Data Requested Mandated
Target Audience: (You MUST check this box.) * World Languages Teachers and Administrators
Maximum Enrollment: (You MUST check this box.) * To be determined
Learning Outcomes: as a result of participating in this Workshop (Activity), participants will be able to... *
Requirement for successful participation: (Check this box) * Attendance at this Workshop
Total Instructional Time (Duration of Workshop) * One Hour Two Hours
Special Facilities, Equipment, or Materials to be used: *
Evaluation Methodology: (Please check all that apply.) * Follow-up Survey / Reaction Survey Discussion Observation Statistical Analysis
Will a follow-up Activity to this (Proposed) Workshop be offered? * Yes No
If Yes, please offer a Brief Description.
...AND FINALLY: Your Resume!

If you are the (Main) Presenter (the one completing this form), please UPLOAD a MOST CURRENT Resume in the UPLOAD FIELD right HERE below.

If you have a Co-Presenter for your Workshop, please MAKE SURE to direct him/her to the "CT COLT Fall Conference 2008 Co-Presenter Resume" form/link, on our www.ctcolt.org website, where he/she too MUST UPLOAD a MOST CURRENT Resume of his/her own, on a SEPARATE form. Thank You!
UPLOAD or ATTACH your RESUME (from a file on your computer) *
ALSO, PLEASE REMEMBER that...

ALL presenters (and your co-presenters), in addition to uploading or attaching a Resume online, MUST email a file copy of it (in MS Word document), to rdemeijctcolt@yahoo.com
PLEASE NOTE:

Since the above Workshop (Activity) is offered for CEUs, this form, AND the Resume of EACH & EVERY presenter, AND the Workshop Proposal form, AND the form completed after each activity has taken place, MUST be available to the CT State Department of Education upon request anytime, for up to three years after the completion of this Workshop (Activity).
Do Not Fill This Out

Wufoo

CTCOLT Fall Conf. '08 - CEU P.D.A. FORM

...AND FINALLY: Your Resume!

ALSO, PLEASE REMEMBER that...

PLEASE NOTE: