PD Fund University Course Application 2021-2022

    Application Form Instructions

    • Applicants are expected to apply a minimum of 10 working days BEFORE the activity occurs in order for the SRTA PD Committee to consider the application prior to the date of the activity.
    • This completed application form will be automatically submitted to pdchair@srteach.org.
    • Any changes in the activity approved by the SRTA PD Committee must be reported to pdchair@srteach.org immediately and is subject to an amending approval from the SRTA PD Committee.

    Please refer to the SRTA PD guidelines for each category’s application deadlines and descriptions.

    Fields marked with an asterisk (*) required.

    Member Information

    1. *Name of Applicant:
    2. *SRSD Email Address:
    3. *Date of application:
    4. *School/Workplace:
    5. *Member Status for 2021-2022:
    6. Effective dates of Term Contract or Leave of Absence:
    7. *Teaching Position:
    8. PD Description

    9. *Date(s) of coursework: to
    10. *Location of coursework:
    11. *Name and brief description of coursework:
    12. *In detail, indicate relevance of coursework PD opportunity. (i.e. PGM, teaching load):
    13. PD Costs

    14. *University coursework costs (maximum per year is $800): $