Request for Services
Curriculum
General Session Information
Date of session:
Start Time:
Lunch Time:
End Time:
Session Address:
Session Location:
Requested Topic:
IU1 Presenter Requested:
Select A Presenter
Amy Dillow
Chantal Fisher
Charisse Bowman
Chris Bokulich
Jordan Lozosky
Katrina Steingrabe
Kristin Miller
Marissa Sacco
Melissa Hunter
Peter Domencic
Renae Kotchman
Robert Garvey
Rodney Hardy
Ronald Gallagher
Samuel Taylor
Sarah Durzo
Teresa Brown
Theresa Edenfield
Tracey Czajkowski
Other Presenter
Other Presenter:
Type of Visit
Face to Face
Virtual
Hours needed:
Special Accomodations
Yes
No
Describe the Accommodations Needed:
Mental Health PD
Yes
No
* No more than 30 participants per training.
Select a package from the list below.
Select a Package
E-Colors in Education
Mindfulness for Staff and Students
SEL Overview
SEL Package-10 days
SEL Package-20 days
Trauma-Informed Schools
Other Mental Health Topics as Requested
OR
Go with a Mental Health PD Bundle. Select 3 topics from the list below.
Mindfulness for Staff and Students
SEL Overview
Trauma-Informed Schools
Other Mental Health Topics as Requested
What identifiable needs will this session address?
District/Charter Information
School District/Charter School:
Select Your District
Albert Gallatin Area School District
Avella Area School District
Bentworth School District
Bethlehem-Center School District
Brownsville Area School District
Burgettstown Area School District
California Area School District
Canon-McMillan School District
Carmichaels Area School District
Central Greene School District
Charleroi School District
Chartiers-Houston School District
Connellsville Area School District
Fort Cherry School District
Frazier School District
Jefferson-Morgan School District
Laurel Highlands School District
McGuffey School District
Peters Township School District
Ringgold School District
Southeastern Greene School District
Trinity Area School District
Uniontown Area School District
Washington School District
West Greene School District
Other District
____________Charter Schools______________
California Academy of Learning Charter School
IU1 Campus McMurray
IU1 Campus Waynesburg
Nonpublic School
Other District:
Contact Name:
Contact Phone:
Ext:
Contact Email:
Contact Title:
Contact Role:
Participants
Grade Level of Participants:
Number of Participants:
Rate the level of prior knowledge on the requested topic:
None
Limited
Significant: This is a follow-up
If significant, describe prior professional development that they have had on this topic:
Materials/Resources
School district will provide:
Technology
Handouts
Projector
SMART Board
White Board
Other:
Is this part of ATSI?:
Yes
No
Is this part of a Contract/Package?:
Yes
No
Number of days:
Dates Requested:
Is this a Statement of Work Request?:
Yes
No
