Dickson County Schools Faculty and Staff In-Service Verification Form

Please enter the following information for the session you are attending or have already attended. You must use this form to get credit for fulfilling your 5 required in-service days. Thank you for your cooperation.

1. Your Assigned School/Department Required Question

2. Please choose your name (ABE)

3. Please choose your name (CENT)

4. Please choose your name (CES)

5. Please choose your name (CMS)

6. Please choose your name (CWHS)

7. Please choose your name (DCHS)

8. Please choose your name (DES)

9. Please choose your name (DMS)

10. Please choose your name (NDA)

11. Please choose your name (OES)

12. Please choose your name (SBES)

13. Please choose your name (SPED)

14. Please choose your name (TDS)

15. Please choose your name (VES)

16. Please choose your name (WBES)

17. Please choose your name (WJMS)

18. Please enter your location

19. Enter your full name

First Name
Middle Initial
Last Name

20. Last 4 digits of SSN

21. Are you Certified or Non-Certified? Required Question

	Certified
	Non-Certified

22. Are you a Full-Time employee or a Part-Time employee? Required Question

	Full-Time Employee
	Part-Time Employee

23. Is this in-service a full day or half day? Required Question

	Full Day
	Half Day

24. Please select the 1/2 day of in-service day you have attended.

25. Please select the 1 day of in-service day you have attended.

26.

Please enter the information for the in-service you attended. Please double check the choices above and make sure you haven't overlooked it in the list.

Name of in-service
Location of in-service
Date of in-service

27. Are you substituting an approved Personal Day or an approved Sick Day for this in-service session? Required Question

	Yes
	No

28. Would you like to receive a copy of your responses? Required Question

	Yes
	No

29. Enter your email address here:

	May 27, 2011 - Technology Training
	May 27, 2011 - Math Collaboration
	June 7, 2011 - USING TILES/SHAPES TO TEACH FRACTIONS
	June 8, 2011 - GRAMMAR MADE EASY
	July 7, 2011 - USING A MODEL CLASSROOM EFFECTIVELY
	July 11, 2011 - HANDS-ON ACTIVITIES FOR ALGEBRA
	July 11, 2011 - RTI, AIMSWEB, AND PLB 2ND GRADE
	July 12, 2011 - GO TAGS – "GETTING OFF TO A GOOD START"
	July 12, 2011 - MATH STRATEGIES FOR THOSE DIFFICULT TO MASTER STANDARDS
	July 12, 2011 - USING MATH MANIPULATIVES EFFECTIVELY IN GRADES K-2
	July 12, 2011 - THE INS AND OUTS OF IEP MEETINGS
	July 12, 2011 - PRIOR WRITTEN NOTICE AND PROCEDURAL SAFEGUARDS
	July 13, 2011 - POWER IN YOUR PLB FOR K-2
	July 13, 2011 - PUT THE POWER IN YOUR POWER LEARNING BLOCK
	July 14, 2011 - CRITICAL THINKING
	July 15, 2011 - CPI PRACTICE & REVIEW
	July 19, 2011 - SMART TABLE TRAINING 8:00 – 11:30
	July 19, 2011 - SMART TABLE TRAINING 12:30 – 4:00
	July 19, 2011 - New Employee Orientation - Alternate session
	July 20, 2011 - DATA BOARDS FOR K-8 SPECIAL EDUCATION
	July 20, 2011 - PHUN (FUN) HOMEWORK
	July 21, 2011 - RTI – ROAD TO INSANITY…..OR IMPROVEMENT
	July 21, 2011 - EARLY CHILDHOOD DAY OF COLLABORATION
	July 21, 2011 - WHAT DOES RIGOR LOOK LIKE IN THE CLASSROOM?
	July 21, 2011 - USING DISTRICT, SCHOOL, AND TEACHER DATA
	July 22, 2011 - New Employee Orientation
	July 29, 2011 - CAREER & TECHNICAL EDUCATION
	July 29, 2011 - SPECIAL EDUCATION IN-SERVICE
	The In-Service is not listed

	June 13, 2011 - CPI (Crisis Prevention Intervention) Re-certification
	June 20, 2011 - CPI (Crisis Prevention Intervention) Re-certification
	June 21, 2011 - CLASSROOM MANAGEMENT TECHNIQUES
	June 28, 2011 – (For Speech Therapists Only) ASPERGER SYNDROME & ACADEMICS
	July 11, 2011 - CPI (Crisis Prevention Intervention) Re-certification
	July 15, 2011 - CREATING CULMINATING ACTIVITIES
	July 18, 2011 - CPI TRAINING (Crisis Prevention Intervention)
	July 19, 2011 - WORKING WITH CHILDREN WITH AUTISM
	July 21, 2011 – (For Speech Therapists Only) AUDITORY-LINGUISTIC PROCESSING DISORDERS
	July 29, 2011 - TITLE ONE IN-SERVICE
	The In-Service is not listed