Professional Development Program

Instructor Cover Sheet

KEYSTONE AEA 1 LICENSURE RENEWAL PROGRAM

This form must be completed in full for all course offerings

Course Title:

Semester: Year: Syllabus: Attached On File

Instructor: Current Vita: Attached On File

Address:

Home Phone: Day Phone:

E-mail:

Credit Hours: Total Contact Hours: # Students: Max: Min:
(Note: There must be 15 contact hours for each hour of academic credit not including break time.)

Location:

Dates and Times:

Required Text:

Title: Date: Price: $

Publisher's Address:

Phone:

Additional Fees:

Lab: $ ($10 automatic fee for participants outside hosting district; may vary)

Materials: $ (include all instructor-provided materials participants must purchase)

Description:

Printing: $ ($5 per participant fee for all printing done through Keystone. Include
originals or forward them asap.)

No Charge; I will handle my own printing needs.

A.V. Equipment Needed: (please list)

Notes:

Estimated Instructor Expenses: (for Keystone-hired instructors only)

(mileage to and from course site only)

Overnight expenses: nights of lodging = $ meals = $

Agency Use

Please address the following components to the best of your ability.

This course addresses the following areas of the Iowa Teaching Standards: (Check those that apply.)

1. Content knowledge
2. Planning and preparation for instruction
3. Multiple learning needs of students
4. Monitoring of student learning
5. Classroom management
6. Fulfills professional responsibilities of school district
7. Engages in professional growth
8. District's student achievement goals

The following Standards for Services apply to this course: (Check those that apply.)

Standards for Services (see attached for description)

1. School-Community Planning
2. Professional Development Services
3. Curriculum, Instruction and Assessment Services
4. Diverse Learning Needs of all Children and Youth
5. Inclusive Schools
6. Media Services
7. School Technology
8. Leadership
9. Management Services

The following Indicators of Quality apply to this course: (Check those that apply.)

Indicators of Quality

1. Teacher, school, and district needs as evidenced in CSIP
2. Student learning needs as evidenced in CSIP
3. Improving student achievement in mathematics
4. Improving student achievement in reading
5. Improving student achievement in science
6. Reducing student achievement gaps in mathematics
7. Reducing student achievement gaps in reading
8. Reducing student achievement gaps in science
9. Reducing dropout rates
10. Preparing students for post-secondary success
11. Plans to assure students complete a core curriculum
12. Improving teaching in mathematics
13. Improving teaching in reading
14. Improving teaching in science
15. Delivering cost-efficient services
16. Delivery of timely services
17. AEAs determine customer satisfaction through high levels of participation
18. AEAs determine customer satisfaction with quality of AEA services

Professional development services - The AEA anticipates and responds to schools' and school districts' needs; supports proven and emerging educational practices; aligns with school and school district comprehensive long-range and annual improvement goals; uses adult learning theory; supports improved teaching; uses theory, demonstration, practice, feedback, and coaching; and addresses professional development activities as required by the Iowa Code or administrative rules.

Curriculum, instruction, and assessment services - These services support the development, implementation, and assessment of rigorous content standards in, but not limited to, reading, mathematics, and science. The AEA assists schools and school districts in gathering and analyzing student achievement data as well as data about the learning environment, compares those data to the external knowledge base, and uses that information to guide school and school district goal setting and implementation of actions to improve student learning.

Diverse learning needs of all children and youth - These services address gifted and talented students and meet the unique needs of students with disabilities who require special education. Services provide support to schools and school districts and include special education compliance with Iowa administrative rules for special education.

Inclusive schools - These services assist schools and school districts to take actions that ensure all students are free from discriminatory acts and practices; to establish policies and take actions that ensure all students are free from harassment; to incorporate into the educational program instructional strategies and student activities related to responsibilities, rights, and the respect for diversity which are necessary for successful citizenship in a diverse community and a global economy; and to incorporate on an ongoing basis activities within professional development that prepare and assist all employees to work effectively with diverse learners and to implement multicultural, gender-fair approaches to the educational program.

Media services - These services align with school and school district needs, support effective instruction, and provide consultation, research and information services, instructional resources, and materials preparation and dissemination to assist schools and school districts to meet the learning needs of all students and support local district media services. These services support the implementation of content standards in, but not limited to, reading, mathematics, and science. These services also support and integrate emerging technology.

School technology services - These services provide technology planning, technical assistance, and professional development, and support the incorporation of instructional technologies to improve student achievement. These services support the implementation of content standards in, but not limited to, reading, mathematics, and science. These services support and integrate emerging technology.

Leadership - Leadership services assist with recruitment, induction, retention, and professional development of educational leaders. AEAs develop and deliver leadership programs based on local and state educational needs and best practices.

Management services - If the AEA provides management services to school districts, the services shall conform to the provisions of Iowa Code section 273.7A.

Keystone Area Education Agency 1
1400 2nd Street NW
Elkader, IA 52043-9564
563-245-1480 or 800-632-5918