Event Request Form

Event Description*
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Price for IAEA Members*
Price for Non-IAEA Members*
Note, there is a minimum suggested $5 fee for PD events.

Professional Development Event
Please complete the questions below to request PD hours. Requests must be submitted 14 days prior to the event. You will be contacted by [email protected] once your request has been received.
I understand that I or the presenter will be responsible for collecting sign in/out for PD Hours*
- Yes
Name of Lead Presenter*
First Last
Email Address of Lead Presenter*
Number of PD Hours Requested*
Please enter a number from .5 to 50.
*Please note: Keynote and meal breaks are not eligible for PD hours.
PD Event Overview*
Provide an overview of your event or activitity. Include a timeline of activities for this event.

Select at least one of the following criteria established for PD activities*
Engages participants over a sustained period of time allowing for analysis, discovery, and application as they relate to student learning, social or emotional achievement, or well-being
Aligns to the licensee’s performance (evaluation)
Includes outcomes that relate to student growth or district improvement
Aligns to State-approved standards
Are college courses
Provide educators with training on the physical and mental health needs of students, student safety, educator ethics, professional conduct, and other topics that address the well-being of students and improve the academic and social-emotional outcomes of students
PD Content Description Part One: Relationship to Criteria*
Describe the content of the PD activity as it relates to one of the criteria you selected above.
PD Content Description Part Two: Impact on Students*
Describe the expected impact on student learning and/or well being.
PD Content Description Part Three: Connection to Standards*
List specific Visual Arts or Media Arts standards addressed by the PD.
Name
This field is for validation purposes and should be left unchanged.

Event Request Form

Professional Development Event

Teaching Standards and Professional Learning Standards