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Professional Development
Needs Assessment Survey


Your input is important to us!  In order to plan professional development opportunities for school staff, we need to know what you are interested in learning more about.  This survey will help to determine what courses will be offered throughout the year and as online courses offered over the Internet.  If you have trouble completing this form or have any questions, please e-mail me at: mbreid@gte.net.

GENERAL INFORMATION

Name
Title
Organization
Work Phone
E-mail

Age Group:

Gender:    Male    Female

Classes & Levels Taught (courses, department, & grade level)

Secondary/High School
High School Subjects Taught:

Middle School
Middle School Subjects Taught:

Elementary
Elementary Subjects/Grade Levels Taught:

Educational Attainment (choose all that apply):

          PhD

Major & Minor:

          Master's  Major & Minor:
          Bachelor's Major & Minor:

Years of teaching experience:

Membership in professional organizations:


Professional journals that you read frequently:


Have you read the standards in the discipline you teach published by the national education organization representing this academic area (e.g., NCTM, NSTA, NCSS, NCTE, etc.)

Yes
No
I am aware they exist, but I have not read them

If so, how frequently do you integrate these standards into lessons and curriculum?

Have you read the state standards in the discipline and/or the grade level you teach?

Yes
No
I am aware they exist, but have not read them

If so, how frequently do you integrate these standards into lessons and curriculum?

Teacher Certification:

Early Childhood
Elementary Education (Multiple Subject)
Middle School/Junior High
Secondary Education (Single Subject)
All Grades
Lifetime Credential
Specialist Credential
No Certification

Subject Area Credential (Mathematics, Art, History, Science, Physical Education, Special Education, etc.)

Your Ideal Time for Professional Development and Workshops:

Early Morning Before School
During the School Day
After School
Evenings
Saturday Morning
Online: Anytime, Anywhere

On average, last year, how many hours weekly did you spend preparing for classes:

On average, last year, how many hours monthly did you spend on professional growth:

Over the past three years, what professional course work have you taken?

Over the past three years, what conferences have you attended?

What areas of professional development would you be interested in taking courses in or learning more about? Please select all that apply then list specific topics for each.

Visual and Performing Arts
Mathematics
Reading
Science
History-Social Studies
Writing
Teaching and Learning
Standards-based Instruction
Classroom Management
GATE
Technology Integration
Other

List specific topics for each of the areas you selected above:


Created by Mary B. Reid
Copyright 2001. All rights reserved.
Revised: April 12, 2001