Professional Development/USF Model Proposal

Professional Developement Proposal

Please provide us with a little more information. Fill out the form and hit the submit button.
(* denotes a required field).

Demographic Information

Name: *

Email: *

Home Phone Number (999-999-9999): *

District: *

Your Title: *

Highest Degree Earned: *

Workshop/Course Title: *

Workshop/Course Description: *

Target Audience: *

Materials/Technology Needed: *



WORKSHOP-complete this section if you a proposing a workshop

What time of day do you prefer?

What day of the week do you prefer?



COURSE-complete this section if you a proposing a course

How many credit hours are being proposed?

What method of delivery is being proposed?

***If you selected ONLINE in the above question, YOU MUST complete a 4-week training called “Preparing to Teach Online” – CLICK THE BUTTON BEOW:

Please enroll me in the next PTTOL (online instruction) course.

Which semester is being proposed for delivery?

If a site-based course is being proposed, where is the course intended to take place?

If you are proposing a course, please download this Adjunct Data Sheet (PDF), by CLICKING HERE complete it and mail it to:
Regional Education Academy for Leadership
3033 West Jefferson
Joliet, IL 60435




Other Questions

Are you willing to work as a consultant within other districts?

Please add any additional information you feel is pertinent here: