Act 48 / Act 45 (PIL) Submission Information

Act 48 / Act 45 (PIL) Submission Information

First Name Address Phone Number Preferred Email:

MI (or Former Last Name) City

PPID* (Required, do NOT include SSN)

Last Name

State

Zip Code

CWID (Cal U #, "C" followed by 8 digits)

Current Pennsylvania Certification:

Course Prefix

Course #

Course Title

Semester Completed

Credits Earned

Check if for

PIL credit:

Check if for

PIL credit:

Check if for

PIL credit:

Check if for

PIL credit:

Check if for

PIL credit:

Check if for

PIL credit:

Check if for

PIL credit:

Check if for

PIL credit: PLEASE NOTE: Final grade must be officially posted on Cal U student account before course information can be submitted to PDE for Act 48 or Act 45 credit. Check for PIL credit ONLY if course is to be submitted for Act 45 hours (currently only for courses with course code beginning with "SLE").

Participant's Signature

Date

Email completed form along with a copy of transcripts to:

Deborah A. Grubb, Assistant Dean

Email: grubb@calu.edu

California University of Pennsylvania College of Education & Liberal Arts 250 University Avenue, Box 66 California, PA 15419

*Effective July 1, 2013, providers will no longer be able to collect Social Security Numbers from educators on continuing professional education activity registration forms, sign-in/sign-out sheets at Act 48 professional development activities, or on forms used to collect information from educators in order to upload credits for completed course work. Educators can find their PPID by going to PDE's website at education.state.pa.us.

Act 48/45 Submission Form ? FALL 2021

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