PI-PDP-3 Goal Approval
|[pic] |Wisconsin Department of Public Instruction |INSTRUCTIONS TO EDUCATOR: Complete Part I and submit to your PDP Team members|
| |PDP GOAL APPROVAL FORM |for signature. |
| |PI-PDP-3 (Rev. 03-14) |INSTRUCTIONS TO PDP TEAM MEMBER: Complete Part II and return to educator. |
| |Initial Educators Only | |
|Professional Development Plan (PDP) forms available at: |
| |I. EDUCATOR INFORMATION | |
|Educator Name |Educator E-Mail Address |Educator File / Entity No.* |
| | | |
|Licensure Category Teacher Administrator Pupil Services |Date Goal Submitted to PDP Team |
| | |
|I HEREBY CERTIFY THAT, by my signature below, under penalty of perjury, that the information submitted by me in this form is true. I am aware that submitting |
|false information in connection with this process may result in non-approval and/or non-renewal of a license and may subject me to civil or criminal penalties. |
|Educator Signature |Date Signed Mo./Day/Yr. |
|( | |
| |II. PDP TEAM MEMBER INFORMATION | |
|Team Member Name |Team Member E-Mail Address |Date Trained As a team member |Educator File / Entity No.* |
| | | | |
|Representing Check one |Check One |
|Teacher Pupil Services Administrator IHE |Goal Approved |
| |Not Approved |
|I HEREBY AFFIRM, by my signature, that the information provided is true and correct. | |
|Signature |Date Signed Mo./Day/Yr. | |
|( | | |
|Team Member Name |Team Member E-Mail Address |Date Trained As a team member |Educator File / Entity No.* |
| | | | |
|Representing Check one |Check One |
|Teacher Pupil Services Administrator IHE |Goal Approved |
| |Not Approved |
|I HEREBY AFFIRM, by my signature, that the information provided is true and correct. | |
|Signature |Date Signed Mo./Day/Yr. | |
|( | | |
|Team Member Name |Team Member E-Mail Address |Date Trained As a team member |Educator File / Entity No.* |
| | | | |
|Representing Check one |Check One |
|Teacher Pupil Services Administrator IHE |Goal Approved |
| |Not Approved |
|I HEREBY AFFIRM, by my signature, that the information provided is true and correct. | |
|Signature |Date Signed Mo./Day/Yr. | |
|( | | |
*Educator file / entity numbers may be found on the DPI Educator License lookup at:
|Note: The initial educator must have this form completed and signed by the PDP team. Retain one copy for your own records and present it to your team along with|
|your completed plan for verification. |
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related download
Related searches
- radians 18 to pi converter
- decimal to pi fraction calculator
- number to pi form calculator
- calculator with the pi button
- calculator with pi and square
- cosx 2cos 2x pi 3 sqrt
- 4cos 2 x pi 3 sin2x 1
- aarp medicare preferred pdp formulary
- aarp medicarerx preferred pdp plan
- aarp medicarerx preferred pdp formulary
- what does sustainable development goal 3 means
- 2 pi 3 in degrees