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VSDB Outreach Professional Development Request
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* Indicates required question
Email
*
Your email
Name
Your answer
School Division
Your answer
Phone number
Your answer
Role
TODHH
TVI
Special Education Director
Program Administrator
Clear selection
Date Professional Development Requested (if you do not need a specific date, please leave this blank)
MM
/
DD
/
YYYY
Alternate dates?
Your answer
What kind of presentation are you requesting? (you can select more than one)
Virtual
In Person (4+ hours)
Recorded
Are CEUs requested?
Yes
No
Clear selection
Who is the target audience?
Your answer
How many attendees do you anticipate?
Your answer
Do you have permission from the Director of Special Education/appropriate personnel to request this training?
Yes
No
Clear selection
Time professional development requested (if you do not need a specific time, please leave this blank)
Time
:
AM
PM
How much time can you spend on professional development?
1 hour
2 hours
3 hours
4 hours
Full Day
Multiple Day
Other:
Clear selection
DHH: Please indicate which topic(s) you are interested in receiving training on. Outreach will contact you to plan specifics after submission of this form.
Language Development
Vocubulary
Assessment
IEP Development
Audiology
Interpreting
Cued Language
Listening and Spoken Language Strategies
Literacy
Math
Writing
Deaf Disabled Learners
Other:
VI: Please indicate which topics you are interested in receiving training on.
Braille instruction/curriculums
Assistive Technology
Assessment
IEP Development
Expanded Core Curriculum
CVI
Instructional strategies
Academic areas
Orientation and Mobility
Other:
Are you willing to use a pre-recorded presentation? (A certificate of attendance can be provided)
Yes
No
Maybe
Clear selection
Additional comments, questions, information:
Your answer
Submit
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