Programs, Activities, and Learning Experiences (PALS) Recording Form

PALS Recording Form

Programs, Activities, and Learning Experiences (PALS)

To BeCompleted by Intermediate Unit I Supervisors or Subcontractors

PLEASE EMAIL COMPLETED FORM TO INSTRUCTIONAL SUPPORT SERVICES

Is this a new Workshop or a new session for an exisitng Workshop? Click to SelectExisting WorkshopNew Workshop

EXACT Activity Title

(For exisitng Workshops, please check Solutionwhere, use exact title as it appears there. Limit 100 characters, avoid special characters like “&”)

Person Submitting PALS Today’s Date Event Start Date

*items in this box to be completed by IU Staff only

Received Date______Completed Date______

Approval –Jenny Lent:______

Select one of the categories from Standard 3: Provides professional education in an approved content area of the Pennsylvania Professional Education Criteria. (If an activity includes several content areas, select the most significant one.

Click to SelectB1 Tchr Content KnowledgeB2 Tchr Teaching SkillsB3 Tchr Assessment Skills and/or Data AnalysisB4 Tchr Working with Parent and Community PartnersB5 Administrators Think and Plan StrategicallyB6 Administrators Access and Use Appropriate DataB7 Administrators Culture of Teaching and LearningB8 Administrators Managing Resources

Areas of interest: Select all that apply – use space barto select/deselect or mouse click.

Rev. 2010 JAN 21

PALS Recording Form

Administration

Adult Education

All Content Areas

Arts/Arts Integration

Assessment

Autism

Career/Technology Center

Classroom Management

Coaches

Common Core/Keystone

Curriculum

Data Tools

Drug and Alcohol

Early Intervention

Economics/Finance

Elementary

Environment/EcologyESL Educators

Family and Consumer

Gifted

Guidance

Health and First Aid

Hearing Impaired

High School

History

Instructional StrategiesInterventions

IU 1 Supervisors

Librarians

Language Arts

Mathematics

Middle School

Music

Non-Public

Nurses

Online

Para Professionals

PVASS

School Improvement

School Law

School Psychologists

Science

Social Studies

Social Workers

Special Education

Speech/Language

Standard Aligned System (SAS)

Strategic Planning

Teaching Techniques and Strategies

Technology

Technology Education

Technology Integration

Visually Impaired

Other

Description for Other

Rev. 2010 JAN 21

PALS Recording Form

Event Narrative: It will be typed in the description portion of the on-line registration format. (Keep this description to a minimum to a minimum of 250 words or less.)

Syllabus (optional)

Target Audience

Learner’s Outcome

Session Information

Is content delivered solely by electronic media? Click to SelectYesNo

Date(s)/Times

Date / Start Time / AM/PM / End Time / AM/PM
AMPM / AMPM
AMPM / AMPM
AMPM / AMPM
AMPM / AMPM
AMPM / AMPM

*If workshop is Internet only, enter beginning and ending dates of session

Last date for registration

Activity Type Click to SelectCPE CourseExtra Contracted DaysInserviceParaprofessional HoursWorkshop for Act 48 HoursNo Credit

Total Activity Hours(Do not include breaks or meals)

Act 48 Hours(Do not include breaks or meals, or non-Act 48 portions of the activity)

NOTE: Should be a minimum of three Act 48 hours.

Cost $

Include food? Just Coffee Coffee & Snacks Meal

If a meal is included, when will meal be served?AMPM

Charge to which account? Click to SelectN/AWorkshopsSpecial EducationFederal ProgramsGrantsOther Description for Other

Additional Cost or other info:

(Handouts must be sent to the IU at least one week prior to need, for duplication.)

Prerequisite:

Select Activity Subject Area Click to SelectTeaching and Learning and Professional DevelopmentStandards Area Curriculum and AssessmentAcademic Content StudiesTechnologyStudent Social and Health IssuesSchool Administration

Contact person - who to call for questions:

Contact person: Phone Ext email

Instructor(s)

Location Room

Maximum number of participants Minimum Class Size

Rev. 2010 JAN 21