The University Of North Dakota - PDE

Professional Development for Educators
Credit Approval Request
Choose the type of Professional Development Option
Face-to-Face, Online, or Blended
Cumulative Credit or "Cafeteria" offerings.

To apply for professional development credit (900 level) approval from the University of North Dakota, submission is preferred 20 business days prior to the start of the event. Credit approval will not be granted for events that are already in progress or have already ended.

Complete the STEPS below. Call Kim or Laura at 1-800-CALL-UND if you have questions. Omissions will cause delays in the approval process.

Credit Approval Request STEPS:



Step #1: Complete the Curriculum Plan for your submission Rename your file, and save it to your computer.
Step #2: Complete the credit approval form below.
Step #1: Please read the Guidelines for Submission
Step #2: Complete the Plan of Action Spreadsheet and Professional Development Event Information Form, providing information for each planned event. (save these files to your computer and complete them. You will upload them before submission)
Step #3: Complete the credit approval form below

* = required field
Instructor of Record Information
*First Name *Last Name
*Position Title *Organization/School
*Work Address *City
*State *Zip
*E-mail *Work Phone #

Have you been an instructor of record through previously approved UND
professional development events? Yes No
Facilitator (if not the instructor of record) Co-Instructor of record (if applicable)

Include information for multiple presenters in the Curriculum Plan
First Name Last Name
Current Position Organization/School
E-mail

Event Information Cumulative Credit Information
Create a name for your overall "cafeteria" program. Credits will be attached to this name and be listed on the participant′s UND transcript. Only Satisfactory or Unsatisfactory (S/U) grading is used for cumulative credit professional development programs.
*Name for cumulative credit *Title of event *Delivery Method
Please identify, with a start date of your first learning event and an end date of your very last learning event, the overall time frame that educators will accumulate “hours” as part of your "Cafeteria" program.
*Event start date *Program start date *Event end date *Program end date
*Sponsoring school district or consortium:
*Maximum number of participants
*Has this event previously been approved by UND? Yes No

*Select academic department for credit approval review
*Number of Credits Requested. One credit is awarded for every 15 hours of direct instruction time. Time for meals, breaks, exhibits, and any other non-instructional activities should not be counted.
1 2 3 4 5
1 2 3 4 5

*Grading Format (you may choose one or both)
Satisfactory or Unsatisfactory (S/U)
Letter Grade A-F (Ltr)

Fill in the following information if applicable for your event.(Required for Face-to-Face and Blended)
NOTE: If you are planning on repeating the same event at different locations, please provide that information in your curriculum plan.
Please provide a schedule of dates and times.
Facility Information
*Facility Name
*Facility City
*State *Zip
*Address
Website Information

 Please complete the following information to help your participants find the event through our web site.

*Target Audience (Choose at least one, and up to two. Hold down ctrl to select multiple audiences)
*Please choose topic areas of interest that apply to this event. (Choose one to three. Hold down ctrl to select multiple interests)

*Briefly describe the topic of the event. (2 sentences)
Fees and Registration
*Is registration restricted or limited to a particular school district/consortium, etc. ? Yes No
*Will the sponsoring host be paying for the participants credit fee?
If yes, please list the name and mailing address of the party to receive a billing statement. Participants will be instructed to select "Third Party Pay"
Yes No
*Will there be an additional fee (other than credit fee) that UND will collect?
If yes, you will be contacted for clarification on the fee amount and purpose. 		Yes No
Contact Information (if different from the instructor of record)
UND correspondence will be sent to the contact that submits this request as well as the instructor of record.
First Name Last Name
Current Position Organization/School
Phone E-mail
Website

please provide any additional event registration information participants will need to know to attend.


Forms
Step #3: *Upload the required curriculum plan for your event
(from Step #1).
Step #4: Upload your resume if you are a new instructor, or a revised resume if you have not provided one in the past three years.
*Step #4: Upload the required plan of action spreadsheet
(from step #2).
*Step #5: Upload your PD Event Information Forms (from step#2).
Step #6: Upload your resume if you are a new instructor. Included a resume for your co-instructor if applicable. A revised resume should be submitted every three years after initial submission.


Step #5: Click submit, you will receive an email confirmation when your application has been received. If you do not hear from us within two weeks after you have recieved an email confirmation, please contact Kim or Laura at 1-800-CALL-UND.

Step #7:Click submit, and your submission will automatically be sent to UND. You will receive a confirmation email upon successful submission. If you do not hear from us within two weeks after you have recieved an email confirmation, please contact Kim or Laura at 1-800-CALL-UND.