CABOT PUBLIC SCHOOLS



Cabot Public Schools

Professional Development Verification Form

2011-2012

Teacher:____________________________________ School:_____________________

60 REQUIRED Hours: Posted in Shoebox

(The employee is responsible for producing original documentation for 5 years as required for licensure renewal by the Arkansas Department of Education.)

5 days Required contract days without students (30 hours)

_____ Monday, August 8, 2011 ___AM ___PM (6 hours)

_____ Tuesday, August 9, 2011 ___AM ___PM (6 hours)

_____ Wednesday, August 10, 2011 ___AM ___PM (6 hours)

_____ Thursday, August 11, 2011 ___AM ___PM (6 hours)

_____ Friday, August 12, 2011 ___AM ___PM (6 hours)

2 days Contract days with students (12 hours)

_____ 12 embedded hours during contract days

3 days Non contact days that FLEX as contract days (18 hours=12 hours of FLEX and 6 hrs of

Technology including CTAT 103)

_____ CTAT 103 (3 hrs) ______ 3 hours additional Technology

_____ 12 hours of FLEX

_____ TOTAL 10 days (60 hours) which includes the following:

Technology □ Parental Involvement □ Arkansas History □

(6 hours) (2 hours) (2 hours-if required)

ADM Requirements □ Arkansas Scholarship Requirement □

(Data/Fin 4 hrs and Parent Inv 3 hours) (7-12 Counselors and Administrators: 3 hr s initial or 1 hr recalib)

I verify that I have completed and documented sixty (60) professional development hours obtained between June 1, 2011 and May 31, 2012 that qualify in at least one or more of the thirteen areas of professional activities designed to improve students’ academic performance as approved by the Arkansas State Board of Education. The employee is responsible for producing original documentation for 5 years as required for licensure renewal by the Arkansas Department of Education.

___________________________________ _______________________________________

Employee signature Date Administrative verification Date

15 INCENTIVE Hours: Posted in Shoebox

Summer workshop hours, college hours, and non-contract hours attended and documented for incentive hours above the 60 hour requirement.

_______ number of incentive hours earned after the required 60 hours

I verify that I have completed and documented a minimum of fifteen (15) additional professional development hours obtained off contract time between June 1, 2011 and May 31, 2012 that qualify in at least one or more of the thirteen areas of professional activities designed to improve students’ academic performance as approved by the Arkansas State Board of Education.

___________________________________ ______________________________________

Employee signature Date Administrative verification Date

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