Greenfield Exempted Village School District

GEVSD
IPDP Form / 1

Revised June 2011

Greenfield Exempted Village School District

Individualized Professional Development Plan (IPDP)

Name: / Submission Date:
Building/Assignment:
Type of License:
Area of Licensure:
Issue Date: / Effective Date:
Expiration Date:
License Renewal Cycle
Select One:
□  1st renewal of 5-year license
□  2nd renewal of 5-year license
□  3rd + renewal of 5-year license
□  Transitioning from certificate to license / IPDP Type
Select One:
□  Initial Proposal
□  Revised proposal
□  Amended Proposal
IPDP Effective Date (Timeline): From______to______
Goals for Professional Development
□  List 3 goals for your professional development learning. (From Data Worksheet.)
□  Indicate which Ohio Educator Standard(s) each goal reflects. (Refer to Standards on Data Worksheet.)
Goal 1
Educator Standard(s):
Goal 2
Educator Standard(s):
Goal 3
Educator Standard(s):
Additional Goals (if applicable):
Educator Standard (s):

Educator Signature Date

Do not mark below this line, for LPDC use only.

□  Revise/Resubmit

Revision Advice:

□  Approved as written

Approval Signature Date

Greenfield Exempted Village School District

IPDP Review Form: Submit with New IPDP

Name ______Certificate/License # ______

Current Assignment______

Date Submitted______License Renewal Date______

This IPDP meets the following standards for professional development: Circle One

PD Standard #1 / PD is purposefully structured to occur over time. / Yes / No
PD Standard #2 / Data sources guided educator toward this PD.
(see Data Worksheet) / Yes / No
PD Standard #3 / PD includes opportunity for collaboration. / Yes / No
PD Standard #4 / PD includes varied learning experiences to accommodate educator’s knowledge and skills. / Yes / No
PD Standard #5 / PD impacts short and long term professional practice and student achievement. / Yes / No
PD Standard #6 / PD results in the acquisition, enhancement or refinement of skills and knowledge. / Yes / No
IPDP is complete, clear and concise. / Yes / No
IPDP is goal oriented and aligned with Ohio Standards for Educators. / Yes / No

□  Revisions needed

□  Approved

LPDC signature______Date ______