JLTC Workshop/Study Circle Request

“Teachers Helping Teachers”

Any person or group wishing to request a workshop or

a study circle should complete this form. 

You may request a particular program or activity and we will make every effort to facilitate the program so that it meets your standards-based professional development request (s).

Let us help you meet your Professional Development needs...In your district, any day including conference days, before, during, or after school.

Workshop Request Form

 

Contact Person: 

Phone:      Email: 

Workshop or Study Circle Requested: 

Level of Training:

Awareness (1-3 hours) Intermediate (4-5 hours) Advanced (15+ hours)

Suggested Presenter: 

Number of Hours:          Prefered Time: 

Prefered Dates (Once, Monthly, Quarterly): 

Preferred Site:

Teacher Center (Watertown) Teacher Center (Glenfield) In District

Preferred Day:

Monday Tuesday Wednesday Thursday Friday Saturday

Estimated No. of Interested Participants:        Grade Level(s): 

In the space below type a brief description of the training activity that you are requesting.  Be sure to include in your descripton a desired format (i.e. a one-session workshop, an extended workshop, a conference, a professional circle, etc.)  Also, please state what participants will learn or be able to do and how the outcomes are related to the NYS Learning Standards. 

Tell us how to get in touch with you:

Name:
E-mail:
Home telephone number:
School telephone number:
School Building:
Grade Level:
Subject: