Your Full Name
Help for Select One:
Additional offering: you are adding another date to a previously approved program
New - first time event is being offered
Update - this is for an additional offering
Program Number (if already issued one)
Help for Program Number (if already issued one)
If this application is for an additional offering to a previously approved program, enter the Program Approval Number here.
Please select from the following statements:
SCECHs for individual sessions in a series
SCECHs upon completion of all sessions in a series
This is a single event
Program Title (cannot be changed once submitted)
Help for Program Title (cannot be changed once submitted)
Title can be no more than 35 characters including spaces.
Help for Choose one:
Hybrid: Program is a combination of face-to-face and virtual/online. Face-to-face: Participants physically attend the complete program. Virtual/Online: Complete program held through some type of virtual/online media
This is a blended/hybrid event
This is a face-to-face event
This a virtual/online event
Same location as that of sponsor?
Help for Same location as that of sponsor?
Is the program being held at the sponsor's address (i.e., at MOISD)?
Help for Event Location
If your event will not be held at the same location as MOISD, the event location name and address is required.
Help for Category
Select the ONE that best describes your event.
Agriscience and Natural Resource
Career and Technical Education
English as a Second Language
Family and Consumer Sciences
Guidance and Counseling
New Administrator Mentor (Non-Content)
New School Psychologist Mentor (Non-Content)
National Board Certification
Vocational Agriscience and Natural Resources
Vocational Health Sciences
Vocational Human Services
World Language and Culture
Elementary School (PreK-5)
Middle School Level (6-8)
Secondary School Level (9-12)
Curriculum Development (Non-Content)
Leadership Skills (Non-Content)
Management/Supervision Skills (Non-Content)
Multicultural Skills (Non-Content)
New School Counselor Mentor (Non-Content)
Parent and/or Community Relations
School Administration (Non-Content)
School Improvement (Non-Content)
SP Rules & Procedures (Non-Content)
Superivising School Counselor (Non-Content)
Supervising School Pyschologist (Non-Content)
Supervising Teacher (Non-Content)
Help for Course Narrative
This is the description that will appear in the State course catalogue. Include basic information to let participant know what the program is about.
Help for Prerequisites?
If there is a program the participants must take prior to this program, please list below. If none, choose NONE.
Yes (please list below)
Prerequisites (if applicable)
Help for Prerequisites (if applicable)
If prerequisites are necessary, please list them here.
Help for Participant Fee
If there is a fee to attend this event, please enter the dollar amount here.
Help for Attendance Method
What will you use to verify that registrants are in attendance? (sign-in sheet, some type of assignment, game, handouts with names, etc)
Is this a conference?
Help for Is this a conference?
A conference has concurrent sessions & keynote.
If this is a conference, enter the minimum number of hours available. Cannot be less than 3 hours.
Help for If this is a conference, enter the minimum number of hours available. Cannot be less than 3 hours.
For example: This is a 3-day conference where each session lasts 5 hours, but a participant doesn't have to attend every session. The minimum this participant can earn is 5 hours.
If this is a conference, enter the maximum number of hours available
Help for If this is a conference, enter the maximum number of hours available
Actual time of instruction. Do not include breaks, lunch, prep time or similar non-instructional activities.
Total Contact Hours
Help for Total Contact Hours
The actual time used for instruction. Do NOT count the welcome, breaks, lunch, dinner speeches, homework, prep time, registration, or similar non-instructional activities.
Enter up to two program descriptors from the PDF document to right.
Help for Enter up to two program descriptors from the PDF document to right.
You must select one, but no more than two.
Help for On-going enrollment?
Program is work at your own pace - participants are uploaded when they complete the program requirements.
Help for IACET Program?
IACET Certificate has been submitted for Coordinator from Educator. (Educator pays for Program Application)
Is Program Restricted?
Help for Is Program Restricted?
If YES, list any restrictions related to the program. Restrictions may include: limited to a specific school, specific teacher group, etc.
Yes (provide info below)
Program Restrictions (if applicable)
Help for Program Restrictions (if applicable)
Enter your program restrictions here.
Upload your agenda here
Help for Upload your agenda here
Attach the final program agenda to this application. The agenda must show specific training subjects. It must also include break times (10-15 minutes for every 2.5 hrs of instruction) and meal breaks (full-day sessions should include a 30-60 minute lunch period). The agenda cannot change from the agenda approved by MDE. If you have any agenda/program changes, the changes must be approved BEFORE THE FIRST DAY OF THE PROGRAM.
ADVISORY: It is a criminal offense to use or attempt to use a SCECH transcript or certificate of completion that is fraudulently obtained, altered, and/or forged to obtain and/or maintain school administrator, teacher, and/or school psychologist certification or other State Board approval.
Number of program offerings
Help for Number of program offerings
How many times will this exact same program be offered/presented?
Beginning date #2
Help for Beginning date #2
If this exact program will be offered more than once, enter in all the dates in the series here.
Ending date #2
Beginning date #3
Ending date #3
Times of Event
Help for Times of Event
For example: 8:30 AM to 3:00 PM
What are the learning outcomes and objectives for your program? (Please provide information on what participants will be able to do as a result of attending, and the overall purpose of the program.)
COLLEGE CONTACT DETAILS
Is this program offered for College/University credit?
College or University contact name and number:
Number of University credits granted?
College Credit: You must attach in writing a statement from the college that the college is aware of, and approves, the program being offered for SCECHs. Following the program, the instructor must provide, in writing, the names of all participants that fully met all program requirements.
Upload college statement
Help for Upload college statement
If applying for college conversion, please upload the college statement (approval) here.
This area contains the contact information and website for the person that participants would contact to get more information about this specific program.
Who will serve as program monitor (full name please)
Help for Who will serve as program monitor (full name please)
The program monitor is typically the person completing this form.
Monitor's phone #
Program website (if applicable)
Help for Program website (if applicable)
If you would like your program details to include a website for participants to view, please include it here.
Originating district (if applicable)
Help for Originating district (if applicable)
If you are not an employee of MOISD (you are having us sponsor your event), please list your district here.
Do you wish to include extra questions in the online Participant Evaluation? The State encourages program-specific questions. These (up to five) can be in any format and added to the standard online evaluation. The Standard Evaluation questions can't be changed and will always go to participants. This is an offer to add your own. Please list up to five below.
Completion of this form does not secure a meeting space on the MOISD campus. To book a room, please choose 'Room Booking' from the Quicklink Menu at the top of this page. To find out if this event is eligible for inclusion on the MOISD registration link, please contact the General Ed Department at 231-592-9613.