Professional Learning Event Credit Approval Application
A state or federal agency, public entity (city, county, park or school district), business, nonprofit organization or individual may make application to the University of Mary for approval of a course, workshop, symposium, seminar, certificate offering, professional learning group (PLC's, book and topical study groups, collaborative teams) or a conference for credit. Application may be made for graduate or undergraduate workshop credit or continuing education units (CEU's). A learning event may be delivered face to face, on line, through a multiple event or series offering.

Credit is offered for true educational experiences, not for participation in entertainment, meals, exhibits, social, or other non-instructional activity.

To earn 1 undergraduate or graduate workshop credit a minimum of 15 hours of direct instructional time is required. A maximum of 3 hours may be earned through related delivered learning events such as workshops, seminars, conferences, online offerings, study groups, book studies or engaged time in application and reflection on application as identified in the work plan. Application may also be made to approve credit for combined or blended delivery through multiple events that accumulate or bank hours toward credit over a specified term.

CEU's may be awarded in increments of 1/1Oth CEU for each hour of direct participation in an organized and approved noncredit continuing education activity offered and managed by a responsible and competent sponsor with academic direction and qualified instruction.

Application Requirements:

To submit your professional learning event for credit, complete ALL elements of the application and submittal. Requirements of this application are designed to meet the requirements approved by the Education Standards and Practice Board of North Dakota for educators and licensure under NDCC Section 67.1-02-02-05.

Continued Education Unit (CEU):
     $ 20.00 per participant/up to 1 CEU
     $25.00/participant/up to 1.5 CEU's
     $ 30.00 per participant/2 or more CEU's

Undergraduate or Graduate Workshop and Professional Learning Credit:
     Undergraduate credit - $40 / 1 credit
     Graduate credit - $45 / 1 credit

Professional Learning Event Credit Application

Title of Professional Development Event:

Date of Submittal: [November 26, 2014]
Intended Audience:

Estimated Audience:

Type of Learning Event: (Check each box indicating the type of event):

Classroom Course
Certificate Offering
Professional Learning Group (PLC's, book or topic study group, collaborative team)
Delivery Method: (Check each box indicating the delivery method or methods):

Blended (combination of face-to-face, online, multiple events)
     If blended, please explain:
Total Credit(s) Requested:

Graduate:     Undergraduate:     CEU:
Description and Purpose of Event:
Please provide a detailed and concise description of the event, its purpose, how the learning event is organized, and the benefits participants will receive by attending.

Event Sponsor:

Event Contact E-Mail:

Event Location:
If multiple locations, please provide all locations

Dates of Event: (including start and end dates)
Please provide all dates (if multiple events, provide dates with locations)

Event Website:

Instructor of Record/Professional Development Coordinator:

First Name:
Last Name:
Work Address:
Daytime Phone:
  E-mail address REQUIRED -- This is the e-mail address that we will use for e-mail confirmation messages and event coordination.
Facilitator/Record Keeper (if someone other than Instructor of Record):

First Name:
Last Name:
Work Address:
Daytime Phone:
Attach resume of Instructor of Record and Facilitator if not currently on file with the University of Mary or on file and older than 3 years. NOTE: only .doc, .docx, .txt, .pdf files allowed. No .wps files, please:
For credit review, indicate from the list below which University of Mary School the event
most closely aligns with:

     School of Education and Behavioral Sciences
     Gary Tharaldson School of Business
     School of Health Sciences
     School of Arts and Sciences

Outline of Topics and Schedule of Event and Credit Plan: (required)

Provide a complete outline and schedule of the proposed learning event.
Attach brochures or published schedules and documentation for any activity other than those described for validation of curriculum, attendance and length of instruction time. (ie. conferences, conventions): NOTE: only .doc, .docx, .txt, .pdf files allowed. No .wps files, please:
Objectives and Outcomes:
What are the overall goals, learning objectives and proposed participant outcomes of the event? What are participants expected to learn from the event, and apply at the conclusion event?

Resources/Course Materials:
What resources/materials will be used throughout the professional development event (books, articles, videos, etc.)? Provide titles of materials and authors.

Explain method of how attendance will be documented. (sign in sheet, session summary, etc.)

Evaluation and Evidence of Learning and Application:
How will participants show evidence of the learning event and application of the knowledge attained? What product, assignment, or course application will be developed to show how the participants will provide their thoughts and reflection on the work accomplished and new strategies? How they will use the new learning?

Grading for this learning event is proposed as

Pass/Fail    Letter Grade
If letter grade is proposed attach grading rubric with application. NOTE: only .doc, .docx, .txt, .pdf files allowed. No .wps files, please:

Submission of Completion and Final Grades:
The submittal of event completion, final attendance, credit summary and final grades is required to be submitted by the Instructor of Record to the University of Mary's Registrar within 10 working days of completion. The estimated date of submittal is ... ?

Type the word in blue: dakota   
IMPORTANT: If you leave this field blank and click "Submit," you will lose all your entered data.

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