KY SPDG Activity Log

1. Activity Description

1. Start date of the activity:
If this activity spans multiple days or months, enter the date the activity began.

	MM		DD		YYYY
Start Date	Start date of the activity: If this activity spans multiple days or months, enter the date the activity began. Start Date Month	/	Day	/	Year

2. Your name:
Enter your name if this is an activity you conducted without the direct assistance of other KY SPDG personnel. If this is a collaborative activity, enter the name of the person serving as the lead provider.

Your name: Enter your name if this is an activity you conducted without the direct assistance of other KY SPDG personnel. If this is a collaborative activity, enter the name of the person serving as the lead provider.

3. If this was a collaborative KY SPDG activity, enter the name(s) of the other SPDG personnel involved.

If this was a collaborative KY SPDG activity, enter the name(s) of the other SPDG personnel involved. Staff 1:
Staff 2:
Staff 3:

4. Provide a simple name for each PD activity entered.( For example, "Provided training on differentiated instruction,” “TA on pre-school literacy,” “Facilitated parent meeting.”)

Provide a simple name for each PD activity entered.( For example, "Provided training on differentiated instruction,” “TA on pre-school literacy,” “Facilitated parent meeting.”) Activity:

5. Please enter a brief, narrative description of the SPDG activity which includes the following
-Description of the audience.
-How the activity was delivered.
-Content of the activity.
-For example – post-secondary transition workshop at Manual HS faculty meeting or parent training at Blue Moon Elementary PTO meeting).

Please enter a brief, narrative description of the SPDG activity which includes the following -Description of the audience. -How the activity was delivered. -Content of the activity. -For example – post-secondary transition workshop at Manual HS faculty meeting or parent training at Blue Moon Elementary PTO meeting).

6. Is this activity a follow-up to a previous professional development activity?
Example: Booster training given to a school implementing PBIS.

Is this activity a follow-up to a previous professional development activity? Example: Booster training given to a school implementing PBIS. Yes

No, a new activity