Curriculum, Staff Development & Related Services:  Request for Services

  Contact Person:
  District: Building:
  Phone: E-mail:
  Brief Description of request:
  Date(s) Requested: Time(s) Requested:
  Intended Audience: Est. # of Participants:
  Location:
  Goal:
  Anticipated Learner Outcomes:
1. 
2. 
3. 
  How does this service align with district goals or Professional Education Plan?  How was the need determined for the service? (Include any relevant data)
  Describe any previous training in this area.
  How will this training/consultation be used to build capacity within the district?  Describe the involvement of other district staff (if any) in the training and the role they play.  Describe follow-up measures to be employed to ensure successful implementation.
 

  Contact Information:

Lori Gerber, Confidential Secretary
Berks County Intermediate Unit
1111 Commons Blvd.
P.O. Box 16050
Reading, PA 19612-6050
Phone: (610) 987-8421
FAX: (610) 987-8406