800 Mickelson Drive - Rapid City, SD 57703-4018
605-394-4034/800-544-8765
FAX 605-394-1789
www.wdt.edu

Dear Colleague:

As a part of an ongoing process to engage in professional development activities while an instructor at Western Dakota Tech, the instructor named below must complete various workshops and other relevant experiences. Would you please help by signing the form below to verify that the individual may receive a specified amount of hours for the experience just completed with you? Your help is greatly appreciated.

Sincerely,

Theresa Scharn

Theresa Scharn

Chair, Credential Committee

Verification of Experience

______has completed

(name of individual)

______hours in ______

(name of experience)

on ______.

(date)

______

(presenter/facilitator) (date)

WDT Mission

Western Dakota Tech is a public institution of higher learning that embraces quality programs, expert faculty and staff, and a commitment to academic excellence to teach the knowledge, skills, and behaviors students need to be successful.