ࡱ> 58234 "bjbj <@,B B TL=4cZq ))))%+Hm-$.aubububububub&fhubc1%+%+c1c1ub))4csEsEsEc1F))asEc1asEsE:]f_)prʡ1]ac0c ^\i1 i0f_if_,%/Z/@sE/4/p%/%/%/ububO;$ %/%/%/cc1c1c1c1i%/%/%/%/%/%/%/%/%/B K: Wisconsin Department of Public Instruction PDP WRITING FORM AND CHECKLIST PI-PDP-1 (Rev. 12-13)INSTRUCTIONS: Use this form when writing your PDP.Professional Development Plan (PDP) forms available at: http://dpi.wi.gov/tepdl/pdp.htmlBIOGRAPHICAL INFORMATIONEducator Name  FORMTEXT      Educator Telephone Area/No.  FORMTEXT      Educator Address Street, City, State, Zip  FORMTEXT       Educator Fax Area/No.  FORMTEXT      E-Mail Address  FORMTEXT      Educator File No.*  FORMTEXT      Educator School District  FORMTEXT      Current Educational Assignment  FORMTEXT      No. of Years in Current Assignment  FORMTEXT   Years of Educational Experience  FORMTEXT   Month/Year PDP Submitted for Goal Approval (Initial Educators Only)  FORMTEXT      Month/Year Plan Submitted for PDP Verification  FORMTEXT      *Educator file numbers may be found on the DPI Educator License lookup at:  HYPERLINK "http://dpi.wi.gov/tepdl/lisearch.html" http://dpi.wi.gov/tepdl/lisearch.html.Present Licensure StageLicensure CategoryDate Current License Expires FORMCHECKBOX  Initial Educator  FORMCHECKBOX  Professional Educator  FORMCHECKBOX  Master Educator FORMCHECKBOX  Teacher  FORMCHECKBOX  Administrator  FORMCHECKBOX  Pupil Services6-30- FORMTEXT     PROFESSIONAL DEVELOPMENT PLANStep I: Preparing to Write the Plan REFLECTION Reflect and prepare to write your PDP goal in Step II. While reflection is a required step in the PDP process, recording your reflection below is optional.  FORMTEXT       Step II: Writing the Plan COMPONENTS A. Description of School and Teaching, Administrative, or Pupil Services Situation  FORMTEXT       Review Checklist for Description of School Situation  FORMCHECKBOX  Did you include a description of your teaching, pupil services, or administrative position?  FORMCHECKBOX  Did you include the number of years you have taught, been an administrator, or been in pupil services?  FORMCHECKBOX  Did you include whether the school is located in an urban, suburban, or rural setting?  FORMCHECKBOX  Did you include the ethnic, special needs, and socioeconomic makeup of the school population?  FORMCHECKBOX  Did you include your building goals/mission and/or district goals/mission? B. Description of Goal to be Addressed It is recommended that you use this stem: I will& (research, study, learn, apply, etc.) So that& (describe what you want to see happening differently with student learning).  FORMTEXT       Review Checklist for Description of the Goal  FORMCHECKBOX  Did you describe how your goal will impact your professional growth?  FORMCHECKBOX  Did you describe how your professional growth will have an impact on student learning? C. Rationale for the Goal: Links to Professional Situation and Wisconsin Educator Standards Based on your reflection, describe the reason for your goal. Describe how your goal is linked to your educational situation, and write out the Wisconsin Educator Standards (two or more) that you will focus on to meet your goal.  FORMTEXT       Review Checklist for Rationale for the Goal  FORMCHECKBOX  Does the rationale tell how your goal connects to your school, teaching, administrative, or pupil services situation? (Choose the category that applies to your situation)  FORMCHECKBOX  Did you write out the Wisconsin Educator Standards that you will focus on to meet your goal? (must select two or more) D. Plan for Assessing and Documenting the Goal: Anticipated Artifacts/Evidence to Demonstrate Professional Growth and its Impact on Student Learning Record the anticipated methods you will use to assess your professional growth and the impact on student learning. It may be helpful to review steps III and IV when writing your assessment plan as they outline what is necessary when documenting your completed plan.  FORMTEXT       Review Checklist for Plan for Assessing and Documenting Achievement of the Goal  FORMCHECKBOX  Did you include in the plan the anticipated methods you will use to assess your professional growth?  FORMCHECKBOX  Did you include in the plan the anticipated methods you will use to assess the impact on student learning? E. Plan to Meet the Goal: Objectives, Activities, Timeline, and Plan for Collaboration Note: Completion dates will be filled in during Step III as each objective/activity is completed. 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Objectives  FORMCHECKBOX  Did you include objectives that directly address the goal?  FORMCHECKBOX  Did you include objectives that are observable and verifiable? 2. Description of Activities and Timelines  FORMCHECKBOX  Did you align your activities with your goal and objectives?  FORMCHECKBOX  Did you extend the activities through multiple years of the licensure cycle?  FORMCHECKBOX  Did you state a timeline for completing the activities? 3. Plan for Collaboration  FORMCHECKBOX  Did you include collaboration with others in your plan? Step III: Annual Review of the PDP Annual reviews are done in years two, three, and four and will be submitted as part of your completed plan in the last year of your licensure cycle. Return to Step II E and enter completion dates for each activity completed. Write a reflection in year two summarizing the progress made towards completing your goal. Indicate, in your reflection, how you grew professionally and/or how your professional growth had an impact on student learning. Write any revisions to your objectives or activities in the revision area. Return to this step annually until your PDP is complete and ready to be submitted for verification. May complete a 3, 4, or 5 year plan. One annual review is required for a three-year plan, two annual reviews are required for a four-year plan, and three annual reviews are required for a five-year plan. Reflection (Year 2)Revision (if needed)Date:  FORMTEXT      Date:  FORMTEXT        FORMTEXT       FORMTEXT       Reflection (Year 3)Revision (if needed)Date:  FORMTEXT      Date:  FORMTEXT        FORMTEXT       FORMTEXT       Reflection (Year 4)Revision (if needed)Date:  FORMTEXT      Date:  FORMTEXT        FORMTEXT       FORMTEXT       Review Checklist for Annual Review  FORMCHECKBOX  Did you include in your reflection how you grew professionally and/or how your professional growth had an impact on student learning?  FORMCHECKBOX  Did you include any revisions to your objectives or activities?  FORMCHECKBOX  Did you fill in completion dates for activities? (refer to Step II E of your plan) Step IV: Documentation of Completion of the PDP Your PDP must include 3-5 artifacts and supporting evidence that document professional growth and the impact of professional growth on student learning. Number and label each artifact (i.e., 1. Student test score analysis). You may use a single artifact that focuses solely on professional growth or the impact on student learning as long as your completed plan includes both types of documented evidence. When attaching artifacts, include the number and label entered below. A. Evidence of Professional Growth and the Impact of Professional Growth on Student Learning Number and label each artifact. Indicate whether each artifact documents professional growth, the impact on student learning, or both. Describe each artifact identifying what is documented and the relationship of the artifact to the goal identified in StepIIB. 1.  FORMTEXT      2.  FORMTEXT      3.  FORMTEXT      4.  FORMTEXT      5.  FORMTEXT       Review Checklist for Evidence of Completion of Your Plan  FORMCHECKBOX  Did you provide three to five artifacts and supporting evidence?  FORMCHECKBOX  Did you describe how your artifacts and supporting evidence document your professional growth?  FORMCHECKBOX  Did you describe how your artifacts and supporting evidence document the impact on student learning? B. Reflection and Summary Describe how you grew professionally in the Wisconsin Educator Standards identified in your PDP. Describe in detail the impact of your professional growth on student learning. Describe how you collaborated with others while working on your PDP.  FORMTEXT       Review Checklist for Summary and Reflection Statement  FORMCHECKBOX  Did you describe how you grew professionally in the Wisconsin Educator standards identified in your plan?  FORMCHECKBOX  Did you describe the impact of your professional growth on student learning?  FORMCHECKBOX  Did you describe how you collaborated with others? C. Submitting the Completed PDP for Plan Verification Submit your completed PDP including your 3-5 artifacts and supporting evidence to a PDP team in the final year of the plan.      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