MyPGS Training Request Form for Schools

Name of Person Completing the Form
Email
School
Course Title
Credit Hours

Total credit hours should not reflect lunch or breaks. Trainings offering additional points over the seat time hours, MUST document follow-up work/implementation commensurate with the points offered (e.g. 8 credits for 6 hours of seat time and 2 hours of additional follow-up/implementation work = 8 credit hours).
Create myLearning Course

Create myLearning Course Yes, I want an Integrated myLearning/Canvas Course No
Credit Hours
Must be between 1 and 2 digits. Currently Entered: 0 digits.
Participants are expected to engage in one hour of learning for every point earned.
Type of Points- ESE and Reading points need to meet specific criteria included in course description. Will be reviewed and approved by district level directors.
ESE Course Criteria:

Type of Points- ESE and Reading points need to meet specific criteria included in course description. Will be reviewed and approved by district level directors.
ESE Course Criteria: In-Service ESE Reading
When planning this training, what determined the need for this offering?
What priority initiative(s) does this training most connect to?

What priority initiative(s) does this training most connect to? High Impact Instruction Data Driven Decisions Collaborative Culture School Safety Community Engagement & Involvement Operations Talent Management Technology and Innovation
Course Description: Please describe the content of this course.
Specific Objectives: What will participants know, understand, & be able to do based on the training?
The participants will
Under the current FLDOE PD Protocol Standards, to be eligible for in-service credit, professional trainings must:

- be supported by needs assessment data related to staff professional performance and/or student academic performance
- include clear learning goals for participants
- include specific implementation components to be completed during and following the training (at the participants work site)
- include a reflection of the impact the new learning/skills had on staff and/or student performance
Implementation Activities:

Select one option from the drop-down choices and then describe how participants will engage in learning and receive feedback from trainers on their performance during and/or after this training. What follow-up work will participants will be expected to complete and how they will reflect on the impact of the new learning.
Select one
Describe the implementation activities:
Evaluation of Impact on Staff and Students

Select one evaluation method for students and one for staff. Then describe how you will assess the impact of the training on student performance AND participant practices.
Student Evaluation Activities: select one
Staff Evaluation Activities: select one
Evaluation Activities description:
Scientific/Research Based: Describe the research support for this training and how it connects to/supports the districts priorities.
Prerequisite(s)/Notes:
Allow users to enroll in multiple sections of the same course?

Allow users to enroll in multiple sections of the same course? Yes No
Audience: Who is this training for? Please list certain schools, job titles etc. If it is for whole staff, please state whole staff
Will staff that attend this training be provided pay from Title 1 funds (including Part A, UniSIG, SIG4, SIG-R or TSSSA)

Will staff that attend this training be provided pay from Title 1 funds (including Part A, UniSIG, SIG4, SIG-R or TSSSA) Yes No
Which funding source is going to be used to pay participants for this professional development?
What type of pay will participants receive for attending this professional development?

What type of pay will participants receive for attending this professional development? Stipend Pay Hourly Pay
Important Information, please read...
1. All Title 1 Part A funded professional development will be paid at the stipend rate. Please make sure to send the completed MIS 524 with original signatures to Finance-Grants after the training for payments to be processed. Copied or scanned MIS 524 forms will not be accepted. 2. A principal signature is required for final approval of this Mach form. There is an option to save and resume if a principal is not available at this time. 3. Ensure that the instructor listed for the course includes the person delivering the training as well as a school-based person. This school-based person will be responsible for entering attendance as well as marking course completion (which will trigger the awarding of points).
Important Information, please read...
1. The completion of this form will only create a professional development course in myPGS. If you are paying HOURLY, you will still need to complete the Mach Form to request additional duty hours found at https://ryu.pasco.k12.fl.us/do-mform/view.php?id=320985. 2. A signed MIS 524 will be required for both stipend and hourly rate. For stipend rate, please make sure to send the completed MIS 524 with original signatures to Finance-Grants after the training for payments to be processed. For hourly rate, please make sure hours are entered into FMP and then send completed the MIS 524 with original signatures to Title 1. Copied or scanned MIS 524 forms will not be accepted. 3. A principal signature is required for final approval of this Mach form. There is an option to save and resume if a principal is not available at this time. 4. Ensure that the instructor listed for the course includes the person delivering the training as well as a school-based person. This school-based person will be responsible for entering attendance as well as marking course completion (which will trigger the awarding of points).
Number of Sections Needed:
1
Section Title:
Location
Training Date Training Date / MM / DD YYYY
Training Start Time Training Start Time : HH MM AM/PM
Training End Time Training End Time : HH MM AM/PM
If you have multiple Class dates/times for this section, please provide the details below:
Wait List

Wait List Yes No
Max Number of Participants:
Release Section Date Release Section Date / MM / DD YYYY
Disable Registration

Disable Registration Yes No
Start of Registration Date Start of Registration Date / MM / DD YYYY
End of Registration Date End of Registration Date / MM / DD YYYY
Contact Person:
Instructors:
Stipend Paid?

Stipend Paid? Yes No
2
Section Title:
Location
Training Date Training Date / MM / DD YYYY
Training Start Time Training Start Time : HH MM AM/PM
Training End Time Training End Time : HH MM AM/PM
If you have multiple Class dates/times for this section, please provide the details below:
Wait List

Wait List Yes No
Max Number of Participants:
Release Section Date Release Section Date / MM / DD YYYY
Disable Registration

Disable Registration Yes No
Start of Registration Date Start of Registration Date / MM / DD YYYY
End of Registration Date End of Registration Date / MM / DD YYYY
Contact Person:
Instructors:
Stipend Paid?

Stipend Paid? Yes No
3
Section Title:
Location
Training Date Training Date / MM / DD YYYY
Training Start Time Training Start Time : HH MM AM/PM
Training End Time Training End Time : HH MM AM/PM
If you have multiple Class dates/times for this section, please provide the details below:
Wait List

Wait List Yes No
Max Number of Participants:
Release Section Date Release Section Date / MM / DD YYYY
Disable Registration

Disable Registration Yes No
Start of Registration Date Start of Registration Date / MM / DD YYYY
End of Registration Date End of Registration Date / MM / DD YYYY
Contact Person:
Instructors:
Stipend Paid?

Stipend Paid? Yes No
4
Section Title:
Location
Training Date Training Date / MM / DD YYYY
Training Start Time Training Start Time : HH MM AM/PM
Training End Time Training End Time : HH MM AM/PM
If you have multiple Class dates/times for this section, please provide the details below:
Wait List

Wait List Yes No
Max Number of Participants:
Release Section Date Release Section Date / MM / DD YYYY
Disable Registration

Disable Registration Yes No
Start of Registration Date Start of Registration Date / MM / DD YYYY
End of Registration Date End of Registration Date / MM / DD YYYY
Contact Person:
Instructors:
Stipend Paid?

Stipend Paid? Yes No
5
Section Title:
Location
Training Date Training Date / MM / DD YYYY
Training Start Time Training Start Time : HH MM AM/PM
Training End Time Training End Time : HH MM AM/PM
If you have multiple Class dates/times for this section, please provide the details below:
Wait List

Wait List Yes No
Max Number of Participants:
Release Section Date Release Section Date / MM / DD YYYY
Disable Registration

Disable Registration Yes No
Start of Registration Date Start of Registration Date / MM / DD YYYY
End of Registration Date End of Registration Date / MM / DD YYYY
Contact Person:
Instructors:
Stipend Paid?

Stipend Paid? Yes No

MyPGS Training Request Form for Schools

MyPGS Training Request Form for Schools

Credit Hours

Under the current FLDOE PD Protocol Standards, to be eligible for in-service credit, professional trainings must:

Implementation Activities:

Evaluation of Impact on Staff and Students

1

2

3

4

5