FORMS AND PROCEDURES

The following forms can be completed on-line using your computer keyboard and then printed or they can be printed out and then completed by hand. Sign forms whenever indicated.

All completed forms must be mailed to:

Lake County Educational Service Center
LPDC Committee, Attention: Julie O'Neil
382 Blackbrook Rd 
Painesville, Ohio  44077

Email: joneil@lakeesc.org
Phone: (440) 350-2563, Ext. 746
Fax: (440) 350-2566

Title of Form or Document	Purpose of Form or Document
Professional Growth Options	Professional Growth options provide educators with options to complete coursework and/or activities.
Form 1 - Application for a Position on the LCESC LPDC	Form 1 - Educators interested in serving on the LPDC Committee should complete this form
Form 2 - Individual Professional Development Plan	Form 2 - IPDP Profile and Goals provides current working status, certificate information, and description of goals, outcomes, timelines and evaluations.
Form 3A - Pre-Approval  Educational Activity Form	Form 3A - Submitted prior to beginning an educational activity; determines local credit awarded for activity.
Form 3B - Pre-Approval Non-Approved Provider Form	Form 3B - Submitted prior to beginning an educational activity presented by a Non-Approved Provider
Form 4 - Summary of Coursework, Conferences, Workshops	Form 4 - Submitted upon completion of a course or attendance at a conference or workshop.
Form 5A - Summary of Educational Activity	Form 5A - Submitted upon completion of an educational activity.
Form 5B -  Educational_Activity_Log	Form 5B - Used by the individual employee to record contact hours for one activity. Must be submitted upon completion of an educational activity.
Professional_Development_Record	Used by individual employees to keep track of the professional development activities.
Appeals	Explanation of the appeals process.
Form 6 - Appeal Form	Used by employee to appeal a decision made by the LPDC.
Form 7	Form 7 - Countywide Appeal Form
Form 8	Form 8 - Educators Leaving a LPDC
Approved PDU-CEU Providers	List of conference providers from whom PDU's/CEU's may be obtained.
Submitting Forms Chart	Visual procedure for certification/license renewal.

INDIVIDUAL PROFESSIONAL DEVELOPMENT PLAN

Professional Growth Options
Option 1: 6 Semester Hours
Requirements:

1. Coursework for semester hours must meet the Standards and Guidelines For Professional Development.
2. Coursework must be taken at an accredited college or university.

Option 2: Approved Professional Development Activities (180 contact hours)
Requirements:

1. Approved Educational Activities must meet the Standards and Guidelines for Professional Development.
2. Individuals designing educational activities must prepare a proposal outlining the planned activities and the number of estimated clock hours requested.

Option 3: Combination of Above
Requirements:

1. Requirements and verifications for each type of activity included must meet the previous descriptions.
2. The combined components must be equivalent to 180 clock hours.
   
   Hour Conversions:
   One Semester Hour = 30 clock hours
   One CEU Hour = 10 clock hours 
   One PDU Hour = 1 clock hour 

    

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