Professional Development Impact Survey
Participant's Name:
E-Mail:
District:
Workshop:
Date
Time
Presenter(s)

 

  1. You recently attended the above-named professional development. Please take a moment to complete this survey.
    Refer to your Professional Development Reflection Plan as you complete the table.

     

    Category

    What I learned:

    How did I use it:
    (Teacher practice)

    How these changes affected student performance:

 

  1. If you can, send us an e-mail with attached evidence that illustrates the change in teacher practice and student performance, as stated above. Please send documents in MS Word, MS Excel or PDF format (i.e., procedural checklists, logs, journals, lesson plans, student work and/or data). E-mail should be sent to: [Bonnie Burt, ISS Department].
     

  2. Would you like any follow-up?
    YES -
    NO  -

    Explain below:
 
 

This form will be submitted to the ISS Dept., DCMO BOCES, 6678 County Road 32, Norwich, NY 13815.

Instructional Support Services.
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