North Carolina Teaching License:

Renewal Activity Reporting Form

Last Name:      First Name:

Activity Area: Teaching (list courses) Date (ex. F99) Units of Credit (1.0 annually)
 

Total for this Area

 

Activity Area: Technology (REQUIRED)
list training		 Date (ex. F99) Units of Credit
 

Total for this Area

 

Activity Area: New Course Development (name course) Date (ex. 3/99, 5/99) Units of Credit (1.0 annually)
 

Total for this Area

 

 

Activity Area:  Course Revision (name course) Date (ex. 4/99, 5/99) Units of Credit (.5 annually)
 

Total for this Area

 

 

Activity Area:  Presenting a Paper (list titles & locations) Date (ex. 6/30/99) Units of Credit (1.0 per paper)
 

Total for this Area

 

Activity Area:  Making a Presentation (list titles & locations) Date (ex. 11/8/99) Units of Credit (.5 per presentation)

  Total for this Area

 

 

Activity Area:  Taking Formal Course Work (list course titles, numbers & locations) Date (ex. F99) Units of Credit (1.5 per semester hour)
  Total for this Area

 

 

Activity Area:  Workshop Attendance (list titles & locations) Date (ex. 4/10/97) Units of Credit (.5 per hour)
 

Total for this Area

 

Activity Area:  Travel Date (ex. 12/20/99) Units of Credit (varies)
 

Total for this Area

 

Activity Area : Article/Book Chapter (publication name also) Date (Publication) Units of Credit (1.0 per article)
  Total for this Area

 

Activity Area:  Monograph Date (1/12/00) Units of Credit (1.0 per monograph)
 

Total for this Area

 

Activity Area:  Book (include publisher) Date (Publication) Units of Credit (3.0 per book)
  Total for this Area

 

Activity Area:  Grants Date (ex.: 9/14/97) Units of Credit (1.5 per grant/contract)
  Total for this Area

 

Activity Area:  Other Date (ex.: 2/14/00) Units of Credit (varies)
  Total for this Area