Suggested recordkeeping form for:

REQUIRED PROFESSIONAL DEVELOPMENT FOR EDUCATORS

NAME SUPER SCHOOL DISTRICT NAME
Educator Name: Beginning Year:
Date of PBTE					Name of evaluator
Mentor		Subject area		Observation date(s)			Meeting/discussions		Year
Beginning Teacher Assistance at: From/to:
Professional Development Class/Courses
Date	Name of Class/Course		Characteristics			Contact Hours		Current Year		Year Total

Initial Certification requires total of 30-contact hours.

Career Certification requires 15-contact hours yearly.

Data Screen:   Educator       (name)          met the yearly requirements to continue his/her current certificate of license to teach.  The number of PD hours completed are:________